Zackary Bryce Whitney, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS17969 Issued in FL

Practice address

409 Summit Ridge PL Apt 107
Longwood, FL 32779-6251

Phone

(435) 215-6012

NPI assigned

Apr 8, 2019

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Dermatology

Education

William Carey University College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surq

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment Care Compare group NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surgery

  • Dermatology Physician
  • The Villages, FL
  • NPI 1417115908
  NPD

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1942763941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SUMMIT RIDGE PL APT 107",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327796251",
            "telephone_number": "435-215-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 SUMMIT RIDGE PL APT 107",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327796251",
            "telephone_number": "435-215-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "ZACKARY",
        "middle_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "6696",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS17969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wheatland Health Community Care Inc.
• Wheatland Health Medical Supply
• Christine Elizabeth White
• Jazmine Syril White
• Lauryn Ashley White, APRN
• Jon D Wiese, MD
• Cara Lynn Wiewiora, D.M.D.
• Tyler Wild
• Jenel Paeztold Wilhite
• Elizabeth Ann Wilkerson

• Dermatology Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.