Individual provider Active NPI

Michael Zaurov, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
National Provider Identifier
1821547886
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201700161NP-PP Issued in OR
Practice address
4035 12TH St Cutoff SE Ste 120
Salem, OR 97302-1754
Phone
(971) 599-3411
Fax
(971) 999-0906
NPI assigned
Sep 30, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201700161NP-PP OR Primary

Addresses

Primary practice location

4035 12TH St Cutoff SE Ste 120
Salem, OR 97302-1754

Mailing address

4035 12TH St Cutoff SE Ste 120
Salem, OR 97302-1754
Phone (971) 599-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190418000998 OR Practitioner - Nurse Practitioner 2163763228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4035 12TH St Cutoff SE
Suite 120
Salem, OR 97302-1754
Phone (971) 599-3411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Zaurov Psychiatry, PC Psychiatric/Mental Health CurrentSince Oct 16, 2018 Accepting new patients

Locations

3787 River Rd N
Ste A
Keizer, OR 97303
Phone (503) 763-1778

4035 12th Street Cutoff
Ste 120
Salem, OR 97302
Phone (503) 371-3121

Organizations & group practices 1

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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1821547886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 12TH ST CUTOFF SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021754",
            "telephone_number": "971-599-3411",
            "fax_number": "971-999-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 12TH ST CUTOFF SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021754",
            "telephone_number": "971-599-3411",
            "fax_number": "971-999-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAUROV",
        "first_name": "MICHAEL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-30",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201700161NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.