NPIMap

Individual provider Active NPI

Ibardo Alonso Zambrano I, M.D.

  • Urology Physician
  • Wilmington, NC
National Provider Identifier
1790104628
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
201901591 Issued in NC
Practice address
1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone
(910) 662-8765
Fax
(910) 362-9123
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MT205760 PA
Urology Physician 208800000X 201901591 NC Primary

Addresses

Primary practice location

1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350

Mailing address

PO Box 936857
Atlanta, GA 31193-5127
Phone (910) 662-8765

Other practice location 1

3400 Civic Center Boulevard
Urology, 3 PCAM West, Rm. 3-334W
philadelphia, PA 19104
Phone (215) 349-5042

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address izambrano785423@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014002884 NC Practitioner - UrologyPractitioner - General Surgery 9032400775 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Surgery
Education
Perelman School of Med at the University of Pennsylvania, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3009 Medical Plaza LN
Southport, NC 28461-5194
Phone (910) 662-9500

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Pender Memorial Hospital Hospital, Burgaw, NC, CCN 341307

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201901591NCMDUrology Physician
MT205760PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Aug 23, 2019 Accepting new patients
Chatham Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
NMG Health Services LLC CurrentSince Aug 19, 2022 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Aug 23, 2019 Accepting new patients
Chatham Hospital Inc Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Aug 19, 2022 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

475 Progress Blvd
Siler City, NC 27344
Phone (919) 799-4000

3009 Medical Plaza Ln
Southport, NC 28461
Phone (910) 454-1234

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1814 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 452-3666

109 Scotts Hill Medical Dr
Ste 204
Wilmington, NC 28411
Phone (910) 662-1960

Interoperability endpoints

  • Direct secure messaging: izambrano785423@direct.novanthealth.org

Organizations & group practices 8

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 4

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1790104628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935127",
            "telephone_number": "910-662-8765",
            "fax_number": "910-362-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035350",
            "telephone_number": "910-662-8765",
            "fax_number": "910-362-9123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Civic Center Boulevard",
            "address_2": "Urology, 3 PCAM West, Rm. 3-334W",
            "address_purpose": "LOCATION",
            "city": "philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-349-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMBRANO",
        "first_name": "IBARDO",
        "middle_name": "ALONSO",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MT205760",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "201901591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "izambrano785423@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3400 Civic Center Boulevard",
            "address_2": "Urology, 3 PCAM West, Rm. 3-334W",
            "city": "philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.