Individual provider Active NPI

Dan M Tzizik, PA

  • Medical Physician Assistant
  • Concord, NH
National Provider Identifier
1891711867
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0323 Issued in NH
Practice address
250 Pleasant St
Concord, NH 03301-7539
Phone
(603) 225-7000
Fax
(603) 230-7218
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0323 NH Primary

Addresses

Primary practice location

250 Pleasant St
Concord, NH 03301-7539

Mailing address

250 Pleasant St
Concord, NH 03301-7539
Phone (603) 225-7000

Other identifiers 1

IdentifierTypeStateIssuer
30334018MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20100929000705 NH Practitioner - Physician Assistant 4082730833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Clearchoicemd, PLLCGroup PAC ID 1850510058, 85 clinicians
Alliance Urgent Care Services LLCGroup PAC ID 6305181215, 25 clinicians

Practice addresses (Care Compare)

1 Beehive Dr
Epping, NH 03042-3310
Phone (603) 526-4635

127 Plaistow Rd
Suite 1
Plaistow, NH 03865-2811
Phone (603) 797-9289

24 Homestead PL
Alton, NH 03809-4913
Phone (603) 822-4713

410 Miracle Mile
Lebanon, NH 03766-2639
Phone (603) 276-3260

558 Mast Rd
Goffstown, NH 03045-5256
Phone (603) 232-1790

636 Lafayette Rd
Seabrook, NH 03874-4298
Phone (603) 457-7830

7 Cinemagic Way
Hooksett, NH 03106-1088
Phone (603) 526-4635

75 Laconia Rd
Suite 500
Tilton, NH 03276-5240
Phone (603) 729-0050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0323NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clearchoicemd, PLLC CurrentSince Jan 12, 2023 Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

410 Miracle Mile
Lebanon, NH 03766
Phone (603) 276-3260

Organizations & group practices 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1891711867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017539",
            "telephone_number": "603-225-7000",
            "fax_number": "603-230-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017539",
            "telephone_number": "603-225-7000",
            "fax_number": "603-230-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TZIZIK",
        "first_name": "DAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30334018",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.