Individual provider Active NPI

Nicole Zembol, MD

  • Family Medicine Physician
  • Janesville, WI
National Provider Identifier
1902648611
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101093 Issued in WI
Practice address
849 Kellogg Ave
Janesville, WI 53546-2808
Phone
(608) 758-7856
NPI assigned
Jun 12, 2024
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 101093 WI Primary

Addresses

Primary practice location

849 Kellogg Ave
Janesville, WI 53546-2808

Mailing address

849 Kellogg Ave
Janesville, WI 53546-2808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20260407003815 WI Practitioner - Family Practice 4688149602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

29624 Network PL
Chicago, IL 60673-1296

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101093WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nzembol116151@direct.mhemail.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1902648611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 KELLOGG AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 KELLOGG AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462808",
            "telephone_number": "608-758-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMBOL",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "101093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.