Individual provider Active NPI

Bethany Marie Zakrzewski, PA

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1750859831
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.2007 Issued in AL
Practice address
201 Governors Dr SW FL 1
Huntsville, AL 35801-5171
Phone
(256) 533-1600
Fax
(256) 539-0856
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.2007 AL Primary
Physician Assistant 363A00000X 3830 TN

Addresses

Primary practice location

201 Governors Dr SW FL 1
Huntsville, AL 35801-5171

Mailing address

201 Governors Dr SW FL 1
Huntsville, AL 35801-5171
Phone (256) 533-1600

Other practice location 1

410 N State Of Franklin Rd Ste 120
Johnson City, TN 37604-6972
Phone (423) 431-2350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220623001016 AL Practitioner - Physician Assistant 2567798416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Hospital Spine and Neuro CenterGroup PAC ID 7214221464, 33 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421

201 Governors Dr SW
FL 1
Huntsville, AL 35801-5171
Phone (256) 533-1600

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3830TNMDOccupational Therapy Assistant
PA.2007ALMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bethany@sanc-al.direct.office.nextgen.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1750859831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW FL 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015171",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW FL 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015171",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 N State Of Franklin Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAKRZEWSKI",
        "first_name": "BETHANY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.2007",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.