Individual provider Active NPI

Philip R Zollars, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
National Provider Identifier
1982684742
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20719 Issued in AZ
Practice address
424 S 56TH St Ste 120
Phoenix, AZ 85034-2177
Phone
(602) 685-5211
Fax
(602) 685-5325
NPI assigned
Jan 18, 2006
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20719 AZ Primary

Addresses

Primary practice location

424 S 56TH St Ste 120
Phoenix, AZ 85034-2177

Mailing address

PO Box 42210
Phoenix, AZ 85080-2210
Phone (623) 889-7403

Other practice location 1

424 S 56th St Ste 110
Phoenix, AZ 85034-2177
Phone (602) 685-5211

Other practice location 2

2109 S 48th St Ste 102
Tempe, AZ 85282-1018
Phone (602) 685-5211

Other identifiers 1

IdentifierTypeStateIssuer
134106MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20719AZMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clin-Path Diagnostics, LLC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Sonoran Radiology LTD PastSince Aug 9, 2020 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, 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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1982684742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850802210",
            "telephone_number": "623-889-7403",
            "fax_number": "623-889-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S 56TH ST STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342177",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S 56th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850342177",
            "country_code": "US",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2109 S 48th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852821018",
            "country_code": "US",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLLARS",
        "first_name": "PHILIP",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "20719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134106",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.