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JON ZACKARY MD
NPI 1366869398
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since March 27, 2014PECOS Enrolled
7060 CLAIREMONT MESA BLVD, SAN DIEGO, CA 92111(619) 528-5164 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 29, 2021, Feb 5, 2016 (2 updates tracked since 2016).

About Jon Zackary Md NPPES

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

JON ZACKARY MD (NPI 1366869398) is an individual student in an organized health care education/training program in San Diego, California, licensed in California (138047) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366869398
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJON ZACKARYCredential: MD
Location Address7060 CLAIREMONT MESA BLVDSan Diego, CA 92111-1003
Mailing Address7060 Clairemont Mesa BlvdSan Diego, CA 92111-1003 · (619) 528-5164
Phone(619) 528-5164
Sole ProprietorNo
Enumeration DateMarch 27, 2014
Last NPPES UpdateNovember 29, 20212 updates tracked since enumeration
✔ NPI 1366869398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CA · 138047
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
7060 CLAIREMONT MESA BLVD, San Diego, CA 92111
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jon Zackary 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.

Medicare Billing Reassignment

Medicare enrollment records show Jon Zackary reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
4.6 mi
Health Maintenance Organization
1288 CAMINO DEL RIO N
San Diego, CA 92108
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1023425972 (877) 608-0044

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

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.

HEATHER FIONA LEE MD
Student in an Organized Health Care Education/Training Program
7060 CLAIREMONT MESA BLVD
SAN DIEGO, CA 92111
San Diego County (619) 528-5000
HAILEE VAN M.D.
Student in an Organized Health Care Education/Training Program
7060 CLAIREMONT MESA BLVD
SAN DIEGO, CA 92111
San Diego County (714) 386-2653
MS. GAIL BETH COHEN
Pharmacist
7060 CLAIREMONT MESA BLVD, FIRST FLOOR OUTPATIENT PHARMACY
SAN DIEGO, CA 92111
San Diego County (858) 573-5301
TU-PHUONG THI DOMPOR-TRAN MD
Family Medicine
7060 CLAIREMONT MESA BLVD
SAN DIEGO, CA 92111
San Diego County (619) 719-0422
DR. TRACY KAM D.O.
Family Medicine
7060 CLAIREMONT MESA BLVD
SAN DIEGO, CA 92111
San Diego County (858) 573-6401
AARON GEOFFREY EDELSTEIN M.D.
Family Medicine
7060 CLAIREMONT MESA BLVD, 6TH FLOOR
SAN DIEGO, CA 92111
San Diego County (858) 573-6401
FLAVIA SALEH M.D.
Family Medicine
7060 CLAIREMONT MESA BLVD
SAN DIEGO, CA 92111
San Diego County (800) 290-5000
JAJA TENG PHARM.D
Pharmacist
7060 CLAIREMONT MESA BLVD, 1ST FLOOR OUTPATIENT PHARMACY
SAN DIEGO, CA 92111
San Diego County (858) 573-5301

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 Jon Zackary's NPI number?

The NPI number for Jon Zackary is 1366869398. It was assigned to this individual provider in the NPPES registry on March 27, 2014.

Where is Jon Zackary located?

Jon Zackary practices at 7060 Clairemont Mesa Blvd, San Diego, CA 92111. The listed phone number is (619) 528-5164.

What is Jon Zackary's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jon Zackary enrolled in Medicare?

Yes. Jon Zackary is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jon Zackary's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jon Zackary reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The 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 Jon Zackary's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jon Zackary was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.