Individual provider Active NPI

Zachary Drew Sebens, MD-MPH

  • Student in an Organized Health Care Education/Training Program
  • St Louis Park, MN
National Provider Identifier
1942055934
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6600 Excelsior Blvd Ste 160
St Louis Park, MN 55426-4713
Phone
(952) 993-7705
NPI assigned
Apr 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6600 Excelsior Blvd Ste 160
St Louis Park, MN 55426-4713

Mailing address

6600 Excelsior Blvd Ste 160
St Louis Park, MN 55426-4713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240801002075 MN Order and Referring Only - Family PracticePractitioner - Family Practice 8820535396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34740MNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1942055934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264713",
            "telephone_number": "952-993-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBENS",
        "first_name": "ZACHARY",
        "middle_name": "DREW",
        "credential": "MD-MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.