DR. MARY SUSAN ZICKEFOOSE M.D.
NPI 1972647147
Family Medicine in Canon City, CO
About Dr. Mary Susan Zickefoose M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARY SUSAN ZICKEFOOSE M.D. (NPI 1972647147) is an individual family medicine provider in Canon City, Colorado, licensed in Colorado (41337) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, is affiliated with Camden Clark Medical Center, and is a graduate of Other (1982).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
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. Mary Susan Zickefoose 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 Reassignments
4Medicare enrollment records show Mary Zickefoose reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Alamosa, CO 81101
- Reassigned Medicare billing, Colorado enrollment
- 203 clinicians in this Medicare group
Crownpoint, NM 87313
- Reassigned Medicare billing, Texas enrollment
- 265 clinicians in this Medicare group
Dickinson, ND 58601
- Reassigned Medicare billing, North Dakota enrollment
- 779 clinicians in this Medicare group
Parkersburg, WV 26101
- Reassigned Medicare billing, West Virginia enrollment
- 461 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Camden Clark Medical Center
Acute Care Hospitals · Parkersburg, WVPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 81212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Mary Zickefoose's NPI number?
The NPI number for Mary Zickefoose is 1972647147. It was assigned to this individual provider in the NPPES registry on February 19, 2007.
Where is Mary Zickefoose located?
Mary Zickefoose practices at 571 Taylor Trl, Canon City, CO 81212. The listed phone number is (719) 275-6200.
What is Mary Zickefoose's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mary Zickefoose enrolled in Medicare?
Yes. Mary Zickefoose 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 organizations bill Medicare for Mary Zickefoose's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Zickefoose reassigns Medicare benefits to 4 organizations: Lutheran Hospital Association Of The San Luis Valley (Alamosa, CO), Dhhs Phs Naihs Crownpoint Hospital (Crownpoint, NM), Sanford Bismarck (Dickinson, ND) and Camden-Clark Physician Corporation (Parkersburg, WV). Each 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 Mary Zickefoose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Zickefoose accept?
Health plans from Blue Cross Blue Shield of North Dakota, Sanford Health Plan and Security Health Plan list Mary Zickefoose 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 Mary Zickefoose affiliated with any hospitals?
According to CMS data, Mary Zickefoose is affiliated with Camden Clark Medical Center.
When was this NPI record last updated?
The NPPES record for Mary Zickefoose was last updated on September 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Dr. Mary Susan Zickefoose, M.D. · NPI 1972647147
Family Medicine physician in Canon City, Colorado. Individual provider, active in the CMS NPPES registry since February 19, 2007.
## Identity
- **NPI:** 1972647147 (Entity type: Individual)
- **Enumerated:** February 19, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 41337 (Colorado)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 571 TAYLOR TRL, Canon City, CO 81212-3600
- **Phone:** (719) 275-6200
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Lutheran Hospital Association Of The San Luis Valley (NPI 1972556744, Alamosa, CO); Dhhs Phs Naihs Crownpoint Hospital (NPI 1114960093, Crownpoint, NM); Sanford Bismarck (NPI 1669524351, Dickinson, ND); Camden-Clark Physician Corporation (NPI 1710125430, Parkersburg, WV) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1982
## Record status
- **NPPES last updated:** September 5, 2013
- **Other identifiers:** Medicare UPIN D71254 (CO); Medicare PIN CO305404 (CO); Medicare ID-Type Unspecified C808127 (CO); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1972647147) · Data from the CMS NPPES public registry.