Individual provider Active NPI

Zachary Paul Zabriskie, MD

  • Pediatric Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1770043390
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
13896242-1205 Issued in UT
Practice address
81 Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-0005
Phone
(801) 581-2121
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X D94055 MD
Pediatric Cardiology Physician 2080P0202X 13896242-1205 UT Primary

Addresses

Primary practice location

81 Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-0005

Mailing address

81 Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-0005
Phone (801) 581-2121

Other practice location 1

600 North Wolfe Street
Baltimore, MD 21287
Phone (410) 955-5000

Other identifiers 1

IdentifierTypeStateIssuer
D94055OtherMDMD MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724004262 UT Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0648505982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13896242-1205UTMDPediatric Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1770043390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MARIO CAPECCHI DR RM 4E217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841120005",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MARIO CAPECCHI DR RM 4E217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841120005",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 North Wolfe Street",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21287",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZABRISKIE",
        "first_name": "ZACHARY",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-04-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MD",
            "license": "D94055",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "13896242-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD MEDICAID",
            "identifier": "D94055",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.