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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MICHAEL ZILLES M.D.
NPI 1013004530
Orthopaedic Surgery in Valley Stream, NY

Active since October 06, 2006PECOS Enrolled
40 E MERRICK RD, VALLEY STREAM, NY 11580(516) 825-1101(718) 766-9763 Get Directions Write a Review

NPPES record last updated: October 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 26, 2026, Feb 6, 2019 (2 updates tracked since 2019).

About Dr. Michael Zilles M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL ZILLES M.D. (NPI 1013004530) is an individual orthopaedic surgery provider in Valley Stream, New York, licensed in New York (203112) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013004530
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. MICHAEL ZILLESCredential: M.D.
Location Address40 E MERRICK RDValley Stream, NY 11580-5947
Mailing Address19 Bradhurst Ave Ste 3100nHawthorne, NY 10532-2140 · (914) 909-9018 · Fax (914) 909-9028
Phone(516) 825-1101
Fax(718) 766-9763
Sole ProprietorYes
Enumeration DateOctober 6, 2006
Last NPPES UpdateOctober 26, 20262 updates tracked since enumeration
NPPES CertifiedOctober 26, 2026
✔ NPI 1013004530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in NY · 203112
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
40 E MERRICK RD, Valley Stream, NY 11580
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael Zilles M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Michael Zilles reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

South Nassau Orthopedic Surgery And Sports Medicine, P.C.
Same address
Orthopaedic Surgery
40 E MERRICK RD
Valley Stream, NY 11580
  • Reassigned Medicare billing, New York enrollment
  • 6 clinicians in this Medicare group
NPI 1154332344 (516) 825-1101
Vi Government Hospital & Health Facilities Corp
1,624 mi
General Acute Care Hospital
9048 SUGAR EST
St Thomas, VI 00802
  • Reassigned Medicare billing, U.S. Virgin Islands enrollment
  • Medicare enrollment name: Vi Government Hospital And Health Facilities Corp
  • 114 clinicians in this Medicare group
NPI 1548712409 (340) 776-8311
Riverton Physician Practices LLC
1,786 mi
Foot Surgery
2002 W SUNSET DR, SUITE 2
Riverton, WY 82501
  • Reassigned Medicare billing, Wyoming enrollment
  • 54 clinicians in this Medicare group
NPI 1326377920 (307) 857-5280

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services11 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11580 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RSO VALLEY STREAM CORPORATION
Eyewear Supplier
40 E MERRICK RD
VALLEY STREAM, NY 11580
Nassau County (516) 825-1416
SOUTH NASSAU ORTHOPEDIC SURGERY AND SPORTS MEDICINE, P.C.
Orthopaedic Surgery
40 E MERRICK RD
VALLEY STREAM, NY 11580
Nassau County (516) 825-1101
SLEEP EXPERTS LAB INC
Clinic/Center (Sleep Disorder Diagnostic)
40 E MERRICK RD, 1ST FL
VALLEY STREAM, NY 11580
Nassau County (800) 276-3229
NATURAL IMAGE HAIR CONCEPTS, INC
Durable Medical Equipment & Medical Supplies
40 E MERRICK RD, SUITE 107
VALLEY STREAM, NY 11580
Nassau County (516) 872-1010
HADMAYA IMGAING INC
Clinic/Center (Magnetic Resonance Imaging (MRI))
40 E MERRICK RD
VALLEY STREAM, NY 11580
Nassau County (929) 842-7565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Zilles's NPI number?

The NPI number for Michael Zilles is 1013004530. It was assigned to this individual provider in the NPPES registry on October 6, 2006.

Where is Michael Zilles located?

Michael Zilles practices at 40 E Merrick Rd, Valley Stream, NY 11580. The listed phone number is (516) 825-1101.

What is Michael Zilles's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Michael Zilles enrolled in Medicare?

Yes. Michael Zilles is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Michael Zilles's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Zilles reassigns Medicare benefits to 3 organizations: South Nassau Orthopedic Surgery And Sports Medicine, P.C. (Valley Stream, NY), Vi Government Hospital & Health Facilities Corp (St Thomas, VI) and Riverton Physician Practices LLC (Riverton, WY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Zilles's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Zilles accept?

Health plans from CareSource and Oscar Health list Michael Zilles as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Zilles was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.