John Clayton Zimbardo

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1308 Issued in SD

Practice address

2805 5TH St
Rapid City, SD 57701-6003

Phone

(605) 755-5700

NPI assigned

Aug 20, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians

Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Great Plains Tribal Chairmen'S Health BoardGroup PAC ID 0648609917, 64 clinicians

Black Hills Orthopedic and Spine Center IncGroup PAC ID 0648172932, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Black Hills Surgical Hospital LLC Hospital, Rapid City, SD, CCN 430091

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jzimbardo.96610@regionalhealth.sdhealthlink.net

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.

• Black Hills Orthopedic & Spine Center, Inc.

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1477523678
  Medicare reassignment Care Compare group
• Black Hills Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1336009646
  Medicare reassignment Care Compare group
• Great Plains Tribal Chairmen'S Health Board

  • Pharmacy
  • Rapid City, SD
  • NPI 1376105452

  TX

  Medicare reassignment Care Compare group
• Monument Health Rapid City Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment Care Compare group
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Monument Health Rapid City Hospital Inc

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Monument Health Rapid City Hospital, Inc.

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1306225222
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Monument Health Rapid City Hospital, Inc.

  • General Acute Care Hospital
  • Rapid City, SD
  • NPI 1437122009
  NPD (past)

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

• Black Hills Surgical Hospital, LLC

  • Special Hospital
  • Rapid City, SD
  • NPI 1679535132
  Care Compare affiliation

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1790332245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CANYON LAKE DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028114",
            "telephone_number": "805-630-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016003",
            "telephone_number": "605-755-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMBARDO",
        "first_name": "JOHN",
        "middle_name": "CLAYTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "1308",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorryn Zephier, DNP
• Karen Kay Zepp, P.A.
• Carol Zielike
• Tiffany Zilka
• Daniel Anthony Zimbardo, BSN
• Kylee Ann Zimbardo, CNP
• Michelle Jean Zimiga, AUD
• Colleen Beth Zimmerman, MSW,CSW,LAC, QMHP
• Kari Zimmerman, FNP-C
• Karron Marie Zopp, CNP

• Physician Assistant in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.