Ellen Zanetakis, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

16096 Issued in OK

Practice address

1430 Terrace Dr
Tulsa, OK 74104-4626

Phone

(918) 748-8024

Fax

(918) 748-8249

NPI assigned

Jul 21, 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

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942220702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TERRACE DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044626",
            "telephone_number": "918-748-8024",
            "fax_number": "918-748-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TERRACE DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044626",
            "telephone_number": "918-748-8024",
            "fax_number": "918-748-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANETAKIS",
        "first_name": "ELLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OK",
            "license": "16096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Antonio Zaldivar, LMSW
• Omar Hernan Zaldivar Jr., A.T.
• Mackenzie Zaloudek, SLPA
• Elizabeth Zamarron
• Kimberly Cassendre Zamor, M.D.
• Michael W Zanetakis
• Sharon Zang, PH.D.
• Mercedes Lazaro Zano, M.D.
• Angela Zanotti, P.A.C.
• Terry L Zanovich, M.D.

• Rheumatology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Rheumatology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.