Individual provider Active NPI

Tamara Zach, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Phoenix, AZ
National Provider Identifier
1962638254
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
44393 Issued in AZ
Practice address
22044 N 44TH St Ste 200
Phoenix, AZ 85050-6104
Phone
(623) 257-7673
Fax
(623) 257-7344
NPI assigned
Jun 1, 2009
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 44393 AZ
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 252479 NY
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 44393 AZ Primary

Addresses

Primary practice location

22044 N 44TH St Ste 200
Phoenix, AZ 85050-6104

Mailing address

22044 N 44TH St Ste 200
Phoenix, AZ 85050-6104
Phone (623) 257-7673

Other identifiers 1

IdentifierTypeStateIssuer
613961MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20110722000715 AZ Practitioner - Pediatric MedicinePractitioner - Other (Physician) 5799823480 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44393AZMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Medical Pavilion PLLC Neurology With Special Qualifications in Child Neurology CurrentSince Feb 18, 2024 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Dec 1, 2011 Accepting new patients
Neurocritical Care and Stroke of Arizona PLLC CurrentSince Dec 15, 2023 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Dec 1, 2011 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine Past Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 301
Glendale, AZ 85306
Phone (480) 412-7474

5310 W Thunderbird Rd
Ste 308
Glendale, AZ 85306
Phone (602) 865-4442

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

1432 S Dobson Rd
Ste 403
Mesa, AZ 85202
Phone (480) 412-7473

111 E Dunlap Ave
Ste 1279
Phoenix, AZ 85020
Phone (480) 331-6721

22044 N 44th St
Ste 200
Phoenix, AZ 85050
Phone (623) 257-7673

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

7575 E Earll Dr
Scottsdale, AZ 85251
Phone (480) 448-7500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1962638254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22044 N 44TH ST STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850506104",
            "telephone_number": "623-257-7673",
            "fax_number": "602-865-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22044 N 44TH ST STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850506104",
            "telephone_number": "623-257-7673",
            "fax_number": "623-257-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACH",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "AZ",
            "license": "44393",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "252479",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AZ",
            "license": "44393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "613961",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.