Individual provider Active NPI

Katherine I Zombik

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1912658279
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA100498 Issued in MA
Practice address
399 Boylston St
Boston, MA 02116-3305
Phone
(857) 384-6986
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA100498 MA Primary

Addresses

Primary practice location

399 Boylston St
Boston, MA 02116-3305

Mailing address

399 Boylston St
Boston, MA 02116-3305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220310001925 NE Practitioner - Physician Assistant 7810382793 Reassigns benefits to 1 organization
I20240624005085 MA Practitioner - Physician Assistant 7810382793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carbon Health Medical Group of Massachusetts PCGroup PAC ID 3971943606, 30 clinicians

Practice addresses (Care Compare)

75 Spring St
Suite 500
West Roxbury, MA 02132-4335
Phone (857) 375-7739

80 Summer St
Suite 1
Boston, MA 02110-1218
Phone (617) 865-2749

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2685NEMDProfessional Counselor
PA100498MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 15, 2024 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 15, 2024 Accepting new patients

Locations

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 549-0212

399 Boylston St
Boston, MA 02116
Phone (617) 852-8390

75 Spring St
Ste 500
West Roxbury, MA 02132
Phone (857) 375-7739

Organizations & group practices 4

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": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1912658279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163305",
            "telephone_number": "857-384-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOMBIK",
        "first_name": "KATHERINE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.