Individual provider Active NPI

Matthew D. Zieske, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Iowa City, IA
National Provider Identifier
1952511404
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
38179 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-1616
Fax
(319) 384-6004
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R-7507 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 38179 IA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 52728 MN

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

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
I20100828000184 MN Practitioner - Pathology 5193849040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Iowa, RJ & L Carver College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud Pathologists PAGroup PAC ID 8921025511, 8 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone 80028883251635

1900 Centracare Cir
Saint Cloud, MN 56303-5000
Phone 320251270057309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38179IAMDAnatomic Pathology & Clinical Pathology Physician
R-7507IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health Systems Current Accepting new patients
St Cloud Pathologists PA CurrentSince Jul 12, 2010 Accepting new patients

Locations

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 2

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 10

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1952511404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616",
            "fax_number": "319-384-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616",
            "fax_number": "319-384-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIESKE",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "R-7507",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "38179",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "52728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.