Individual provider Active NPI

Robert W Zickler, M.D.

  • Vascular Surgery Physician
  • Gastonia, NC
National Provider Identifier
1912914714
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2012-00441 Issued in NC
Practice address
2555 Court Dr
Ste 200
Gastonia, NC 28054-2134
Phone
(704) 867-2141
Fax
(704) 867-2308
NPI assigned
Aug 2, 2006
Last updated
Apr 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01067280A IN
Vascular Surgery Physician 2086S0129X 2012-00441 NC Primary

Addresses

Primary practice location

2555 Court Dr
Ste 200
Gastonia, NC 28054-2134

Mailing address

2555 Court Dr
Ste 200
Gastonia, NC 28054-2134
Phone (704) 867-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120925000322 NC Practitioner - Vascular Surgery 3072571082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Hahnemann University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1000 Caromont Pkwy
Belmont, NC 28012-0140
Phone (704) 834-2000

2000 Caromont Pkwy
Belmont, NC 28012-0158

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01067280AINMDVascular Surgery Physician
2012-00441NCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Jun 21, 2012 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Cardiac Surgery Associates SC Past Accepting new patients
Caromont Medical Group Inc Past Accepting new patients
St. Francis Hospital and Health Centers Vascular Surgery Past Accepting new patients
St. Francis Medical Group, LLC Past Accepting new patients

Locations

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

2555 Court Dr
Ste 200
Gastonia, NC 28054
Phone (704) 671-7670

2555 Court Dr
Ste 300
Gastonia, NC 28054
Phone (704) 834-3278

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1912914714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZICKLER",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01067280A",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2012-00441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.