Active NPI
Richard Zysko
- Contractor
- Broadview HTS, OH
National Provider Identifier
1881057735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1403
- Practice address
- 308 Countryside Dr
Broadview HTS, OH 44147-3412 - Phone
- (440) 384-0728
- NPI assigned
- Mar 29, 2016
- Last updated
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 1403 | OH | Primary |
Addresses
Primary practice location
308 Countryside Dr
Broadview HTS, OH 44147-3412
Mailing address
308 Countryside Dr
Broadview HTS, OH 44147-3412
Phone (440) 384-0728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1403 | OH | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1881057735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 COUNTRYSIDE DR",
"city": "BROADVIEW HTS",
"state": "OH",
"postal_code": "441473412",
"telephone_number": "440-384-0728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 COUNTRYSIDE DR",
"city": "BROADVIEW HTS",
"state": "OH",
"postal_code": "441473412",
"telephone_number": "440-384-0728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZYSKO",
"first_name": "RICHARD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "1403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broadview HTS, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.