ANNIE ZAMBRANO (PA-C) – Physician Assistant, NPI 1962716514

ANNIE ZAMBRANO (PA-C) is a healthcare provider. based in Melrose park, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 085.003806 (IL). The NPI Number for ANNIE ZAMBRANO (PA-C) is 1962716514

Main info

Female
Sole Proprietor
17 Years Of Experience
Name
ANNIE ZAMBRANO (PA-C)
NPI
1962716514
Phone
(708) 486-2700
Address
1111 SUPERIOR ST
Enumeration Date
5 August 2010
Last Update Date
13 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6308379000
Graduation Year
2009 (17 years ago)
PAC ID
7719170703
Group Practice PAC ID
1759291461
Professional Enrollment ID
I20101022000502
Address ID
IL601073201ST1400XRDXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for ANNIE ZAMBRANO (PA-C)

  • 1111 SUPERIOR ST

    SUITE 104

    MELROSE PARK, IL 601604138

    Phone: (708) 486-2700

    Fax: (708) 486-2702

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101022000502IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60160)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759291461View full group profile
NameSpecialtyState
P S Y C H I A T R YIL
Psychiatry, General PracticeIL
P S Y C H I A T R YTN
P S Y C H I A T R YSC
P S Y C H I A T R YIN
P S Y C H I A T R YIL
P S Y C H I A T R YIN
Psychiatry, NeuropsychiatryIL
-IL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What number should I use to identify ANNIE ZAMBRANO (PA-C) for billing?
Administrative and clinical systems typically use NPI 1962716514 for ANNIE ZAMBRANO (PA-C).
Does the public listing show ANNIE ZAMBRANO (PA-C) as active?
ANNIE ZAMBRANO (PA-C)'s NPI record reflects an active status in NPPES.
Which specialty label fits ANNIE ZAMBRANO (PA-C)?
NPPES ties ANNIE ZAMBRANO (PA-C) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to ANNIE ZAMBRANO (PA-C)?
ANNIE ZAMBRANO (PA-C) shows a connection to Melrose Park, Illinois in registry-derived data.
Can I export ANNIE ZAMBRANO (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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