Individual provider Active NPI

Nicolas James Zastrow, PA

  • Surgical Physician Assistant
  • Sun City West, AZ
National Provider Identifier
1972797173
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3658 Issued in AZ
Practice address
14520 W Granite Valley Dr
Suite 210
Sun City West, AZ 85375-5855
Phone
(623) 537-5600
Fax
(866) 939-2673
NPI assigned
Aug 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3658 AZ
Medical Physician Assistant 363AM0700X 3658 AZ
Surgical Physician Assistant 363AS0400X 3658 AZ Primary

Addresses

Primary practice location

14520 W Granite Valley Dr
Suite 210
Sun City West, AZ 85375-5855

Mailing address

18444 N 25TH Ave
Suite 310
Phoenix, AZ 85023-1261
Phone (623) 537-5600

Other identifiers 5

IdentifierTypeStateIssuer
5550830007OtherAZMEDICARE NSC DV
5550830003OtherAZMEDICARE NSC PEORIA
5550830001OtherAZMEDICARE NSC SCW
5550830009OtherAZMEDICARE NSC AZ NORTH
5550830010OtherAZMEDICARE NSC GILBERT

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000204 AZ Practitioner - Physician Assistant 6709970312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

19636 N 27TH Ave
Suite 201
Phoenix, AZ 85027-4015
Phone (623) 516-4400

33423 N 32ND Ave
Phoenix, AZ 85085-8874

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3658AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Aug 31, 2020 Accepting new patients
District Medical Group, Inc CurrentSince Apr 21, 2010 Accepting new patients
District Medical Group, Inc CurrentSince Apr 21, 2010 Accepting new patients
Honorhealth Ambulatory CurrentSince Aug 31, 2020 Accepting new patients
Honorhealth Ambulatory Medical Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

33423 N 32nd Ave
Ste 2200
Phoenix, AZ 85085
Phone (480) 398-1550

33423 N 32nd Ave
Ste 101
Phoenix, AZ 85085

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Interoperability endpoints

  • Direct secure messaging: nzastrow398712@direct.honorhealth.com

Organizations & group practices 7

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 4

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": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1972797173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "SUITE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14520 W GRANITE VALLEY DR",
            "address_2": "SUITE 210",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755855",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZASTROW",
        "first_name": "NICOLAS",
        "middle_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3658",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3658",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC DV",
            "identifier": "5550830007",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC PEORIA",
            "identifier": "5550830003",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC SCW",
            "identifier": "5550830001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC AZ NORTH",
            "identifier": "5550830009",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC GILBERT",
            "identifier": "5550830010",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.