Mark N Zacks, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MZ035093 Issued in MI

Practice address

8619 W Grand River Ave
Ste. J
Brighton, MI 48116-2334

Phone

(810) 227-6793

Fax

(810) 227-5397

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Allergy Clinic of Livingston County PC

  • Allergy & Immunology Physician
  • Brighton, MI
  • NPI 1154538619
  NPD (past) Authorized official
• Lakeside Neurology P C

  • Neurology Physician
  • Warren, MI
  • NPI 1982725735
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1881658953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 W GRAND RIVER AVE",
            "address_2": "STE. J",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481162334",
            "telephone_number": "810-227-6793",
            "fax_number": "810-227-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 W GRAND RIVER AVE",
            "address_2": "STE. J",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481162334",
            "telephone_number": "810-227-6793",
            "fax_number": "810-227-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKS",
        "first_name": "MARK",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "MZ035093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST HEALTH",
            "identifier": "1144084",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "M011067",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "93648A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "11217890",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4840320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM &BCN",
            "identifier": "700D711040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christie K Young, LMSW
• John Patrick Young, LPC
• Lauren Young, LMSW, ACSW
• Stephanie Kay Young, MD
• Your Path Counseling of Michigan LLC
• Kerri Zandberg, RN, IBCLC
• Bruce Stanley Zapor, DC
• Melissa A Zarow, D.O.
• Kosai Zaya
• Lindsey R Zietz, LLPC

• Allergy & Immunology Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.