Individual provider Active NPI

Zoe Mae Mackay Zacker

  • Physician Assistant
  • Gary, IN
National Provider Identifier
1982422358
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004698A Issued in IN
Practice address
600 Grant St
Gary, IN 46402-6099
Phone
(219) 866-4000
NPI assigned
Oct 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10004698A IN Primary

Addresses

Primary practice location

600 Grant St
Gary, IN 46402-6099

Mailing address

506 Timbers TRL
Saint Charles, IL 60174-1198
Phone (630) 841-1990

Other practice location 1

8701 Broadway
Merrillville, IN 46410-7035
Phone (219) 738-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250109000774 IN Practitioner - Physician Assistant 1355879081 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10004698AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jan 6, 2025 Accepting new patients
Cep America LLC CurrentSince Jan 6, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1982422358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 TIMBERS TRL",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741198",
            "telephone_number": "630-841-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026099",
            "telephone_number": "219-866-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 Broadway",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107035",
            "country_code": "US",
            "telephone_number": "219-738-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAY ZACKER",
        "first_name": "ZOE",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004698A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.