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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.

ZACHARY THOMAS SELF MD
NPI 1104628635
Internal Medicine in Augusta, GA

Active since March 25, 2025PECOS Enrolled
1120 15TH ST, AUGUSTA, GA 30912(706) 721-4451 Get Directions Write a Review

NPPES record last updated: September 16, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 16, 2026, Mar 25, 2025 (2 updates tracked since 2025).

About Zachary Thomas Self Md NPPES

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

ZACHARY THOMAS SELF MD (NPI 1104628635) is an individual internal medicine provider in Augusta, Georgia, licensed in Missouri (2026043807) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Fort Gordon.

NPPES Registry Identity

NPI1104628635
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameZACHARY THOMAS SELFCredential: MD
Location Address1120 15TH STAugusta, GA 30912-0004
Mailing Address1120 15th StAugusta, GA 30912-0004 · (706) 721-4451
Phone(706) 721-4451
Sole ProprietorNo
Enumeration DateMarch 25, 2025
Last NPPES UpdateSeptember 16, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2026
✔ NPI 1104628635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MO · 2026043807✔ Licensed in GA · 113889
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1120 15TH ST, Augusta, GA 30912
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Secondary Practice Location 1

Location 1300 East Hospital RoadFort Gordon, GA 30905 · Phone (706) 787-6945

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Zachary Thomas Self Md 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
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 20

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

DR. TOYA HESTER KELLEY MD
Family Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-3157
DR. JACK BRADLEY ELLIS D.O.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
SAMI MOHAMMED ALSHEHRY
Student in an Organized Health Care Education/Training Program
1120 15TH ST, 1065
AUGUSTA, GA 30912
Richmond County (706) 721-2411
LUIS ALBERTO VELASQUEZ ZARATE M.D
Pathology (Anatomic Pathology & Clinical Pathology)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-2771
DR. BRYAN RICHARD BROACH M.D.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
JANELLE MCGILL M.D.
Pediatrics
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
DR. KAYLA ASHLEY SHAHBAZIAN DO
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
ROSA MARIA LOPEZ RINCON
Anesthesiology
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 446-5836

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 Zachary Self's NPI number?

The NPI number for Zachary Self is 1104628635. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Where is Zachary Self located?

Zachary Self practices at 1120 15th St, Augusta, GA 30912. The listed phone number is (706) 721-4451.

What is Zachary Self's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Zachary Self enrolled in Medicare?

Yes. Zachary Self is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Zachary Self was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.