DR. THEODORE ZWERDLING MD
NPI 1861475865
Pediatrics in Paradise, CA

Q: What is Theodore Zwerdling's NPI number?

The NPI number for Theodore Zwerdling is 1861475865. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Q: What is Theodore Zwerdling's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since November 22, 2005PECOS Enrolled

78.28/100

CMS Quality Rating

5125 SKYWAY, PARADISE, CA 95969(530) 872-2000(530) 332-1049 Get Directions Write a Review

NPPES record last updated: July 23, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 23, 2019, Aug 25, 2017 (2 updates tracked since 2017).

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About Dr. Theodore Zwerdling Md NPPES

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

DR. THEODORE ZWERDLING MD (NPI 1861475865) is an individual pediatrics provider in Paradise, California, licensed in California (G52223) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861475865

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. THEODORE ZWERDLINGCredential: MD

Location Address5125 SKYWAYParadise, CA 95969

Mailing Address5125 SkywayParadise, CA 95969-5624 · (530) 872-2000 · Fax (530) 332-1049

Phone(530) 872-2000

Fax(530) 332-1049

Sole ProprietorNo

Enumeration DateNovember 22, 2005

Last NPPES UpdateJuly 23, 20192 updates tracked since enumeration

✔ NPI 1861475865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · G52223

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedPediatrics · Pediatric Hematology-OncologyTaxonomy 2080P0207X · License G52223 (CA)

5125 SKYWAY, Paradise, CA 95969

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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)

Dr. Theodore Zwerdling 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 Theodore Zwerdling reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Adventist Health Clearlake Hospital Inc.

77 mi

Critical Access

15630 18TH AVE
Clearlake, CA 95422

Reassigned Medicare billing, California enrollment
182 clinicians in this Medicare group

NPI 1124018031 (707) 994-6486

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

Areas of Expertise CMS Part B claims 2

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.

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

47 services43 patients

Advance care planning, each additional 30 minutes 99498

Advance care planning involves discussing and documenting your future health care preferences in case you're unable to make decisions for yourself. Each additional 30 minutes allows more time to explore your wishes, values, and goals for treatment.

23 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95969 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

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

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.

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.

78.28/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

71.31

Promoting Interoperability

Improvement Activities

Cost

45.47

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.

DOUGLAS L. EDGAR P.A.

Physician Assistant