JOHN CLAYTON ZIMBARDO
NPI 1790332245
Physician Assistant in Rapid City, SD

Active since August 20, 2019PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
2805 5TH ST, RAPID CITY, SD 57701(605) 755-5700 Get Directions Write a Review

NPPES record last updated: November 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 14, 2021, Aug 20, 2019 (2 updates tracked since 2019).

About John Clayton Zimbardo NPPES

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

JOHN CLAYTON ZIMBARDO (NPI 1790332245) is an individual physician assistant in Rapid City, South Dakota, licensed in South Dakota (1308) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS, is affiliated with Black Hills Surgical Hospital Llp, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1790332245
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOHN CLAYTON ZIMBARDO
Location Address2805 5TH STRapid City, SD 57701-6003
Mailing Address3200 Canyon Lake DrRapid City, SD 57702-8114 · (805) 630-0816
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 20, 2019
Last NPPES UpdateNovember 29, 20242 updates tracked since enumeration
NPPES CertifiedNovember 29, 2024
NPI 1790332245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in SD · 1308
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 1308 (SD)
2805 5TH ST, Rapid City, SD 57701

Accepted 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

John Clayton Zimbardo 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 ID8729319959
PECOS Enrollment IDI20210806001910, I20230405000025
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.

Areas of Expertise CMS Part B claims 6

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.
190 services183 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
65 services64 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.
24 services24 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
13 services12 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
13 services13 patients
Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635
This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Black Hills Surgical Hospital LLP

Acute Care Hospitals · Rapid City, SD
OwnershipProprietary
CMS Certification Number430091
Location216 Anamaria DrRapid City, SD 57703 · Pennington County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57701 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
$85.21 typical visit price
range $55.52 – $167.23
Typical copayment $21.30 (range $13.88 – $41.80)
Most-billed visit code 99203
Established Patient
$69.20 typical visit price
range $18.08 – $137.08
Typical copayment $17.30 (range $4.52 – $34.27)
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.

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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

Urology
2805 5TH ST, SUITE 100
RAPID CITY, SD 57701
Internal Medicine (Pulmonary Disease)
2805 5TH ST, SUITE 100
RAPID CITY, SD 57701
Neurological Surgery
2805 5TH ST, SUITE 100
RAPID CITY, SD 57701
Dermatology
2805 5TH ST
RAPID CITY, SD 57701
Physician Assistant
2805 5TH ST
RAPID CITY, SD 57701
Physician Assistant (Medical)
2805 5TH ST, 220
RAPID CITY, SD 57701
Neurological Surgery
2805 5TH ST
RAPID CITY, SD 57701
Orthopaedic Surgery
2805 5TH ST
RAPID CITY, SD 57701

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 John Zimbardo's NPI number?

The NPI number for John Zimbardo is 1790332245. It was assigned to this individual provider in the NPPES registry on August 20, 2019.

Where is John Zimbardo located?

John Zimbardo practices at 2805 5th St, Rapid City, SD 57701. The listed phone number is (605) 755-5700.

What is John Zimbardo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is John Zimbardo enrolled in Medicare?

Yes. John Zimbardo 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 John Zimbardo accept?

Health plans from Avera Health Plans, Medica, Oscar Insurance Company and Sanford Health Plan list John Zimbardo 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.

Is John Zimbardo affiliated with any hospitals?

According to CMS data, John Zimbardo is affiliated with Black Hills Surgical Hospital LLP.

When was this NPI record last updated?

The NPPES record for John Zimbardo was last updated on November 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.