DR. PHILLIP MICHAEL ZEGELBONE M.D.
NPI 1417319195
Pediatrics - Pediatric Cardiology in Miami, FL
About Dr. Phillip Michael Zegelbone M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PHILLIP MICHAEL ZEGELBONE M.D. (NPI 1417319195) is an individual pediatric cardiology provider in Miami, Florida, licensed in Florida (ME156543) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Phillip Michael Zegelbone M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Phillip Zegelbone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33136
- Reassigned Medicare billing, Florida enrollment
- 3,639 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
MIAMI, FL 33136
MIAMI, FL 33136
MIAMI, FL 33136
MIAMI, FL 33136
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 Phillip Zegelbone's NPI number?
The NPI number for Phillip Zegelbone is 1417319195. It was assigned to this individual provider in the NPPES registry on March 22, 2016.
Where is Phillip Zegelbone located?
Phillip Zegelbone practices at 1611 NW 12th Ave, Miami, FL 33136. The listed phone number is (305) 585-5437.
What is Phillip Zegelbone's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.
Is Phillip Zegelbone enrolled in Medicare?
Yes. Phillip Zegelbone is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Phillip Zegelbone's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Zegelbone reassigns Medicare benefits to University Of Miami (Miami, FL). 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 Phillip Zegelbone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Phillip Zegelbone accept?
Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare and 2 other insurers list Phillip Zegelbone 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 Phillip Zegelbone was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Dr. Phillip Michael Zegelbone, M.D. · NPI 1417319195
Pediatric Cardiology physician in Miami, Florida. Individual provider, active in the CMS NPPES registry since March 22, 2016.
## Identity
- **NPI:** 1417319195 (Entity type: Individual)
- **Enumerated:** March 22, 2016
- **Primary specialty:** Pediatrics - Pediatric Cardiology · taxonomy 2080P0202X
- **State license:** ME156543 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 1611 NW 12TH AVE, Miami, FL 33136-1005
- **Phone:** (305) 585-5437
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Of Miami (NPI 1922058544, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** February 6, 2025
- **Other identifiers:** Medicaid 1174118-00 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1417319195) · Data from the CMS NPPES public registry.