Individual provider Active NPI

Nathan Zacharias, M.D.

  • Family Medicine Physician
  • Fort Defiance, AZ
National Provider Identifier
1902255847
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A154803 Issued in CA
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116029272 VA
Family Medicine Physician 207Q00000X 12357371-1205 UT
Family Medicine Physician 207Q00000X A154803 CA Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210427001261 TX Practitioner - Family PracticePractitioner - Other (Physician) 6002100252 Reassigns benefits to 2 organizations
I20220421002454 UT Practitioner - Family PracticePractitioner - Hospice/Palliative Care 6002100252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082

PO Box
Suite 649
Fort Defiance, AZ 86504-0649

Hospital & facility affiliations

  • Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154803CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Partners for Health CurrentSince Apr 23, 2022 Accepting new patients
Utah Partners for Health CurrentSince Apr 23, 2022 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Apr 26, 2021 Accepting new patients
Cirrusmd Medical Group of Delaware, P.a. Family Medicine CurrentSince Oct 11, 2025 Accepting new patients

Locations

3000 Lawrence St
#101
Denver, CO 80205
Phone (720) 996-0522

3513 Brighton Blvd
Ste 230
Denver, CO 80216
Phone (303) 653-7720

3000 Lawrence St
Ste 101
Denver, CO 80205

6844 Bardstown Rd
Louisville, KY 40291
Phone (216) 303-1265

865 State Route 33
Ste 3
Freehold, NJ 07728
Phone (424) 292-2923

7651 S Main St
Midvale, UT 84047
Phone (801) 255-5814

8446 S Harrison St
Midvale, UT 84047
Phone (801) 417-0131

9103 S 1300 W
Ste 102
West Jordan, UT 84088
Phone (801) 208-2070

Organizations & group practices 5

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1902255847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAS",
        "first_name": "NATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116029272",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12357371-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A154803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.