Individual provider Active NPI

Alan Danilo Zevallos, M.D

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1962846683
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77226 Issued in GA
Practice address
4700 Waters Avenue, University Medical Center,
Internal Medicine Residency Program, Memorial Health
Savannah, GA 31404
Phone
(912) 350-0583
NPI assigned
Apr 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77226 GA Primary

Addresses

Primary practice location

4700 Waters Avenue, University Medical Center,
Internal Medicine Residency Program, Memorial Health
Savannah, GA 31404

Mailing address

3350 Commons Gate BND
Berkeley Lake, GA 30092-4969
Phone (678) 799-6074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP
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
I20181212001634 MP Practitioner - Internal Medicine 5991089260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Healthcare CorporationGroup PAC ID 7719075167, 79 clinicians

Practice addresses (Care Compare)

1 Lower Navy Hill Rd
Saipan, MP 96950
Phone (670) 234-8950

Hospital & facility affiliations

  • Commonwealth Health Center Hospital, Garapan, MP, CCN 660001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77226GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Oct 8, 2018 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Oct 8, 2018 Accepting new patients

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 1

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1962846683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 COMMONS GATE BND",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300924969",
            "telephone_number": "678-799-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVENUE, UNIVERSITY MEDICAL CENTER,",
            "address_2": "INTERNAL MEDICINE RESIDENCY PROGRAM, MEMORIAL HEALTH",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEVALLOS",
        "first_name": "ALAN",
        "middle_name": "DANILO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "77226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.