Organization Active NPI

Kathleen J Dennis-Zarate MD a Medical Corp

  • Ophthalmology Physician
  • Glendale, CA
National Provider Identifier
1811076342
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G81715 Issued in CA
Legal business name
KATHLEEN J DENNIS-ZARATE MD A MEDICAL CORP
Practice address
222 W Eulalia St
Suite 110
Glendale, CA 91204-2849
Phone
(818) 551-7127
Fax
(818) 551-7131
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Mrs. Jenny Ramirez, M.D.
Title
Office Manager
Phone
(818) 551-7127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G81715 CA Primary

Addresses

Primary practice location

222 W Eulalia St
Suite 110
Glendale, CA 91204-2849

Mailing address

222 W Eulalia St
Suite 110
Glendale, CA 91204-2849
Phone (818) 551-7127

Other identifiers 2

IdentifierTypeStateIssuer
GR0095000MedicaidCA
1811076342MedicaidCA

Other names 1

  • Kathleen J Dennis-Zarate MD INC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040903001054 CA Part B Supplier - Clinic/Group Practice 7517933187 Receives reassigned benefits from 2 practitioners
Practice locations: Glendale, CA; Montrose, CA

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
05D2092585Kathleen J Dennis-Zarate, MD a Medical Corp Inc222 W Eulalia St Ste 110, Glendale, CA 91204Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kathleen Dennis-Zarate MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2330 Honolulu Ave
Montrose, CA 91020
Phone (818) 249-6447

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1811076342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-551-7127",
            "fax_number": "818-551-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-551-7127",
            "fax_number": "818-551-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN J DENNIS-ZARATE MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-551-7127",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G81715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811076342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kathleen J Dennis-Zarate MD INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.