Patricia Marie Zajac, CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R-01817222 Issued in MN

Practice address

17705 Hutchins Dr
Suite101
Minnetonka, MN 55345-4145

Phone

(952) 401-8300

NPI assigned

Feb 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• South Lake Clinic, P.a.

  dba South Lake Pediatrics

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1427027184
  NPD

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932172137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR",
            "address_2": "SUITE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454145",
            "telephone_number": "954-401-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR",
            "address_2": "SUITE101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454145",
            "telephone_number": "952-401-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R-01817222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8D705ZA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1200856",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "106273",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "CP9041014218",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Igorevna Yurchenko, MD
• Amran Muse Yusuf
• Hafsa Muse Yusuf
• Jeffrey John Zachman, CRNA
• Linda Lucille Zachman, CRNA
• Kathleen Johanna Zakroczynski, MSN, APRN, NP-C
• Kathleen Mae Zamorano
• Daniel Aaron Zander, MS-CCC-A
• Sara M Zank, APNP
• Brian Zehetner

• Pediatric Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.