Individual provider Active NPI

Matthew M Zahn, MD

  • Pediatric Infectious Diseases Physician
  • Santa Ana, CA
National Provider Identifier
1871577833
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
C55094 Issued in CA
Practice address
1719 W 17TH St
Santa Ana, CA 92706-2316
Phone
(714) 834-8180
Fax
(714) 834-8196
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X C55094 CA Primary

Addresses

Primary practice location

1719 W 17TH St
Santa Ana, CA 92706-2316

Mailing address

1719 W 17TH St
Santa Ana, CA 92706-2316
Phone (714) 834-8180

Other identifiers 2

IdentifierTypeStateIssuer
200305040MedicaidIN
64087281MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151223000775 CA Practitioner - Pediatric MedicinePractitioner - Infectious Disease 9830168400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Infectious Disease
Education
Saint Louis University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (888) 770-2462

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55094CAMDPharmacist
C55094CAMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital of Orange County Pediatric Infectious Diseases CurrentSince Oct 13, 2018 Accepting new patients
Louisville-Jefferson County Metro Government Past Accepting new patients
Louisville-Jefferson County Metro Government Past Accepting new patients
University Pediatrics Infectious Diseases, LLC Pediatric Infectious Diseases Past Accepting new patients

Locations

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1871577833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062316",
            "telephone_number": "714-834-8180",
            "fax_number": "714-834-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062316",
            "telephone_number": "714-834-8180",
            "fax_number": "714-834-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHN",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "C55094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200305040",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64087281",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.