Misty Michelle Zelk, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C54385 Issued in CA

Practice address

652 Petaluma Ave
Suite H
Sebastopol, CA 95472-4256

Phone

(707) 823-7616

NPI assigned

Jul 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal MedicineAlso: Pediatric Medicine

Education

University of Arkansas College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Healdsburg Hospital Hospital, Healdsburg, CA, CCN 051321
• Spring Lake Village Nursing home, Santa Rosa, CA, CCN 555268

Merit-based Incentive Payment System (MIPS)

Final score

91.9 of 100Reported as group

Quality

81.89

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: misty.michelle.zelk@359951357313028.direct.elationemr.com
• Direct secure messaging: mzelk@yourcarecommunity.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Front Porch Communities and Services

  • Skilled Nursing Facility
  • Santa Rosa, CA
  • NPI 1609549112

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Marcus Zachary, D.O., P.C.

  • Family Medicine Physician
  • Fresno, CA
  • NPI 1710592621
  NPD
• Palm Drive Health Care District

  • General Acute Care Hospital
  • Sebastopol, CA
  • NPI 1851614523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Front Porch Communities and Services

  • Skilled Nursing Facility
  • Santa Rosa, CA
  • NPI 1609549112

  Nursing home

  Care Compare affiliation
• Norcal Healthconnect LLC

  • Multi-Specialty Clinic/Center
  • Healdsburg, CA
  • NPI 1720695547

  Hospital

  Care Compare affiliation
• Norcal Healthconnect LLC

  • Critical Access Hospital
  • Healdsburg, CA
  • NPI 1861009672
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1205865870
  Care Compare affiliation

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1962401463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "address_2": "SUITE H",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724281",
            "telephone_number": "707-823-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE",
            "address_2": "SUITE H",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724256",
            "telephone_number": "707-823-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELK",
        "first_name": "MISTY",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-1505",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-1505",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C54385",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C54385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140545001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Yeomans, LCSW
• Oksana Kroshna Zakinov, DDS
• Mikaela Marie Zechlin, M.A., LMFT#91176
• Emily Joan Zeinal, DC
• Majid Zeinal, D.C.
• Stephen Peter Zilber, DACM, LAC

• Internal Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.