Individual provider Active NPI

Mark Ali Zacharek, M.D.

  • Otolaryngology Physician
  • Ann Arbor, MI
National Provider Identifier
1932275302
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301065870 Issued in MI
Practice address
1500 E Medical Center Dr
1St Floor Taubman Ctr Recp a
Ann Arbor, MI 48109-5312
Phone
(734) 936-8051
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301065870 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
1St Floor Taubman Ctr Recp a
Ann Arbor, MI 48109-5312

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040818001279 MI Practitioner - Otolaryngology 7214900067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-8051

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone (734) 936-8051

39901 Traditions Dr
Northville, MI 48168-9493
Phone (734) 936-8051

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Aug 31, 2010 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Otolaryngology CurrentSince Aug 31, 2010 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Fl 1
Ann Arbor, MI 48109
Phone (734) 936-4054

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
#700
Ann Arbor, MI 48108

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

19900 Haggerty Rd
Ste 103
Livonia, MI 48152
Phone (734) 432-7634

19900 Haggerty Rd
Ste 100
Livonia, MI 48152
Phone (248) 432-7801

19900 Haggerty Rd
Livonia, MI 48152
Phone (734) 432-7811

Interoperability endpoints

  • Direct secure messaging: mzacharek22337@direct.med.umich.edu

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.

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1932275302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "1ST FLOOR TAUBMAN CTR RECP A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095312",
            "telephone_number": "734-936-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHAREK",
        "first_name": "MARK",
        "middle_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301065870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.