Individual provider Active NPI

Alexander Zemtsov, MD

  • Dermatology Physician
  • Muncie, IN
National Provider Identifier
1811901184
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01042745A Issued in IN
Practice address
3500 W Purdue Ave
Muncie, IN 47304-6357
Phone
(765) 747-6090
Fax
(765) 747-5069
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01042745A IN Primary

Addresses

Primary practice location

3500 W Purdue Ave
Muncie, IN 47304-6357

Mailing address

3500 W Purdue Ave
Muncie, IN 47304-6357
Phone (765) 747-6090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329000487 IN Practitioner - Dermatology 1759332570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Dermatology Center PCGroup PAC ID 5496706210, 12 clinicians

Practice addresses (Care Compare)

3500 W Purdue Ave
Muncie, IN 47304-6357
Phone 7657476090206

Merit-based Incentive Payment System (MIPS)

Final score
88.17 of 100Reported as individual
Quality
78.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision48
Removal of skin lesions189
Removal of skin cancer281
Removal or shaving of skin growth24
Skin biopsy140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042745AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
University Dermatology, Inc. Dermatology CurrentSince Apr 1, 2005 Accepting new patients
University Dermatology Center PC CurrentSince Feb 26, 1995 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7593 Solutions Ctr
Chicago, IL 60677

1473 E State Road 44
Ste 1
Connersville, IN 47331

550 University Blvd
#3240
Indianapolis, IN 46202
Phone (317) 274-7740

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2525 W University Ave
Ste 402
Muncie, IN 47303
Phone (317) 747-6090

3500 W Purdue Ave
Muncie, IN 47304
Phone (765) 286-0236

830 Sim Hodgin Pkwy
Richmond, IN 47374
Phone (765) 939-7664

1185 Wayne Ave
Greenville, OH 45331
Phone (937) 396-1605

Interoperability endpoints

  • Direct secure messaging: azemtsov@direct.iuhealth.org

Organizations & group practices 4

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1811901184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046357",
            "telephone_number": "765-747-6090",
            "fax_number": "765-747-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046357",
            "telephone_number": "765-747-6090",
            "fax_number": "765-747-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMTSOV",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2024-02-19",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01042745A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.