NPIMap

Individual provider Active NPI

David M. Zisa, M.D.

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1962404848
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD034478E Issued in PA
Practice address
1403 Rhawn St
Philadelphia, PA 19111-2803
Phone
(215) 728-6688
Fax
(215) 342-1337
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD034478E PA Primary

Addresses

Primary practice location

1403 Rhawn St
Philadelphia, PA 19111-2803

Mailing address

1403 Rhawn St
Philadelphia, PA 19111-2803
Phone (215) 728-6688

Other identifiers 1

IdentifierTypeStateIssuer
5430305MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.zisa.1@16196.direct.athenahealth.com Direct Nazareth Physician Services, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000322 PA Practitioner - Gastroenterology 4183510969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Hahnemann University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3807

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy66
Upper gastrointestinal (GI) endoscopy for acid reflux46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD034478EPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FCG LLC Gastroenterology Current Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Aug 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Aug 1, 2023 Accepting new patients

Locations

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

1403 Rhawn St
Philadelphia, PA 19111
Phone (215) 332-8100

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Interoperability endpoints

  • Direct secure messaging: dzisa2016149@direct.trinity-health.org

Organizations & group practices 5

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 8

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1962404848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112803",
            "telephone_number": "215-728-6688",
            "fax_number": "215-342-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112803",
            "telephone_number": "215-728-6688",
            "fax_number": "215-342-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISA",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD034478E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5430305",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.zisa.1@16196.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Nazareth Physician Services Direct Email Address",
            "affiliationName": "Nazareth Physician Services, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1403 Rhawn St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191112803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.