Individual provider Active NPI

Andrew Czeslaw Zaleski, MD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Nokomis, FL
National Provider Identifier
1780650101
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
0101030715 Issued in VA
Practice address
2401 Uppakrik LN
Nokomis, FL 34275-1755
Phone
(941) 412-1613
Fax
(941) 412-1613
NPI assigned
Feb 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X ME 84809 FL
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 0101030715 VA Primary

Addresses

Primary practice location

2401 Uppakrik LN
Nokomis, FL 34275-1755

Mailing address

2401 Uppakrik Lane
Nokomis, FL 34275
Phone (941) 412-1613

Other identifiers 2

IdentifierTypeStateIssuer
269472700MedicaidFL
P00768151OtherVARR MEDICARE VA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
112917NYMDClinical Social Worker
ME 84809FLMDSports Medicine (Neuromusculoskeletal Medicine) Physician
0101030715VAMDSports Medicine (Neuromusculoskeletal Medicine) Physician
11141AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Past Accepting new patients
Southeast Volusia Medical Services Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1780650101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 UPPAKRIK LANE",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "34275",
            "telephone_number": "941-412-1613",
            "fax_number": "941-412-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 UPPAKRIK LN",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342751755",
            "telephone_number": "941-412-1613",
            "fax_number": "941-412-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALESKI",
        "first_name": "ANDREW",
        "middle_name": "CZESLAW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-25",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME 84809",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "VA",
            "license": "0101030715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269472700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE VA",
            "identifier": "P00768151",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nokomis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.