Individual provider Active NPI

Zachary Michael Gibbemeyer, PA-C

  • Physician Assistant
  • Bellevue, KY
National Provider Identifier
1922696350
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006796 Issued in OH
Practice address
239 Grandview Ave Apt 201
Bellevue, KY 41073-1573
Phone
(513) 405-1386
NPI assigned
Dec 31, 2020
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 50.006796 OH Primary

Addresses

Primary practice location

239 Grandview Ave Apt 201
Bellevue, KY 41073-1573

Mailing address

239 Grandview Ave Apt 201
Bellevue, KY 41073-1573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, DC, TX, MA, VA, WA, NJ, NV, MD, CO10 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 10

Enrollment IDStateProvider typePAC IDDetails
I20210602000460 OH Practitioner - Physician Assistant 0941609515 Reassigns benefits to 3 organizations
I20221012000099 DC Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization
I20221018003306 TX Practitioner - Physician Assistant 0941609515
I20221219002419 MA Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization
I20221220001146 VA Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization
I20230329002156 WA Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization
I20230809003826 NJ Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization
I20231228003110 NV Practitioner - Physician Assistant 0941609515
I20240419000215 MD Practitioner - Physician Assistant 0941609515
I20260611004541 CO Practitioner - Physician Assistant 0941609515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Health Navigation LLCGroup PAC ID 5294960696, 57 clinicians
Dispatch Health Medical PCGroup PAC ID 9436490562, 15 clinicians

Practice addresses (Care Compare)

1951 Kidwell Dr
Suite 101
Vienna, VA 22182-3930
Phone (702) 848-4443

2 Park Way
1B
Upper Saddle River, NJ 07458-2345
Phone (201) 882-7526

3825 N Lafayette St
Denver, CO 80205-3316
Phone (303) 500-1518

50 Tice Blvd
Suite A35
Woodcliff Lake, NJ 07677-7681
Phone (201) 882-7526

Merit-based Incentive Payment System (MIPS)

Final score
50.5 of 100Reported as group
Quality
44.61
Promoting interoperability
0
Improvement activities
40
Cost
50.57

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
63.66

Merit-based Incentive Payment System (MIPS)

Final score
64.75 of 100Reported as group
Quality
55.37
Improvement activities
40
Cost
47.65

Merit-based Incentive Payment System (MIPS)

Final score
56.11 of 100Reported as group
Quality
50.63
Improvement activities
40
Cost
27.55

Merit-based Incentive Payment System (MIPS)

Final score
65.27 of 100Reported as group
Quality
45.09
Improvement activities
40
Cost
66.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006796OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Wound Healing LLC Family Medicine CurrentSince Feb 16, 2026 Accepting new patients
True North Health Navigation LLC CurrentSince May 17, 2023 Accepting new patients
Dispatchhealth Advanced Care - Washington PC PastSince Oct 21, 2020 Accepting new patients
True North Health Navigation LLC Past Accepting new patients
Excella Home Health Agency, LLC Past Accepting new patients

Locations

3825 N Lafayette St
Denver, CO 80205
Phone (303) 505-1518

1 W Court Sq
Ste 750
Decatur, GA 30030
Phone (404) 494-7888

6371 Riverside Dr
Ste 1100
Dublin, OH 43017
Phone (614) 516-6980

Interoperability endpoints

  • Direct secure messaging: zachary.gibbemeyer.1@13869.direct.athenahealth.com

Organizations & group practices 11

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": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1922696350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 GRANDVIEW AVE APT 201",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 GRANDVIEW AVE APT 201",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731573",
            "telephone_number": "513-405-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBEMEYER",
        "first_name": "ZACHARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, KY

Sources for this page

Verify at the official NPI Registry.