Organization Active NPI

Michael J Zawisza, DO, PC

  • Family Medicine Physician
  • Schuylkill Haven, PA
National Provider Identifier
1790801660
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MICHAEL J ZAWISZA, DO, PC
Practice address
523 S Garfield Ave
Schuylkill Haven, PA 17972-1107
Phone
(570) 385-3826
Fax
(570) 385-4125
NPI assigned
Mar 22, 2007
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Joseph Zawisza, DONPI 1942468210
Title
President
Phone
(570) 385-3826

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

523 S Garfield Ave
Schuylkill Haven, PA 17972-1107

Mailing address

523 S Garfield Ave
Schuylkill Haven, PA 17972-1107
Phone (570) 385-3826

Other practice location 1

211 W Market St
Orwigsburg, PA 17961-1868
Phone (570) 385-3826

Other identifiers 2

IdentifierTypeStateIssuer
563795OtherHIGHMARK BS
010041265OtherPATRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040709000905 PA Part B Supplier - Clinic/Group Practice 0446238182 Receives reassigned benefits from 2 practitioners
Practice locations: Orwigsburg, PA; Schuylkill Haven, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0723778Michael J Zawisza DO PC523 South Garfield Avenue, Schuylkill Haven, PA 17972Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

31 Valley St
New Philadelphia, PA 17959
Phone (570) 277-6556

523 S Garfield Ave
Schuylkill Haven, PA 17972
Phone (570) 385-3826

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1790801660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S GARFIELD AVE",
            "city": "SCHUYLKILL HAVEN",
            "state": "PA",
            "postal_code": "179721107",
            "telephone_number": "570-385-3826",
            "fax_number": "570-385-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S GARFIELD AVE",
            "city": "SCHUYLKILL HAVEN",
            "state": "PA",
            "postal_code": "179721107",
            "telephone_number": "570-385-3826",
            "fax_number": "570-385-4125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 W Market St",
            "address_purpose": "LOCATION",
            "city": "Orwigsburg",
            "state": "PA",
            "postal_code": "179611868",
            "country_code": "US",
            "telephone_number": "570-385-3826",
            "fax_number": "570-385-1425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL J ZAWISZA, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "ZAWISZA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-385-3826",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "563795",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "010041265",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schuylkill Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.