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DR. PHILLIP MICHAEL ZEGELBONE M.D.
NPI 1417319195
Pediatrics - Pediatric Cardiology in Miami, FL

Active since March 22, 2016PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
1611 NW 12TH AVE, MIAMI, FL 33136(305) 585-5437 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 6, 2025, Jan 31, 2023, Aug 30, 2019 and 1 more (4 updates tracked since 2016).

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

NPI1417319195
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. PHILLIP MICHAEL ZEGELBONECredential: M.D.
Location Address1611 NW 12TH AVEMiami, FL 33136-1005
Mailing Address1611 Nw 12th AveMiami, FL 33136-1005 · (954) 554-8906
Phone(305) 585-5437
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 22, 2016
Last NPPES UpdateFebruary 6, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2025
✔ NPI 1417319195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in FL · ME156543
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License ME156543 (FL)
1611 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 1

Medicaid1174118-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID3678864030
PECOS Enrollment IDI20230315000689
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 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.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

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. AKUA GYANEWAH ASARE MD
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 355-8264
MARILUZ SANCHEZ PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1611 NW 12TH AVE, PHARMACY ADM. OFFICES/EAST TOWER BASEMENT 069
MIAMI, FL 33136
Miami-Dade County (305) 585-7309
DR. TASHA JOYTI N. D. COOKE TASHA COOKE
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-3670
DR. JUANITA ANN MARIE HUNTER M.D.
Pediatrics (Pediatric Cardiology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-6042
WANDA LAVERNE MCGOWAN-BRAYNEN ARNP
Nurse Practitioner (Adult Health)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1111
DR. PERTTI KALEVI HAKALA M.D.
Anesthesiology
1611 NW 12TH AVE, CENTRAL 300
MIAMI, FL 33136
Miami-Dade County (305) 585-6970
JAYLOU M VELEZ TORRES M.D.
Pathology (Anatomic Pathology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-8381
ANNE-ISABELLE SOPHIA REME MD
Surgery
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1280

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.

What insurance does Phillip Zegelbone accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare, Oscar Health Maintenance Organization of Florida and UnitedHealthcare 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 18 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.