Dr Khaleelur R Zackariya Sr, MD is a medicare enrolled "Internal Medicine - Addiction Medicine" physician in Mishiwaka, Indiana. His current practice location is
5215 Holycross Parkway, Mishiwaka, Indiana. You can reach out to his office (for appointments etc.) via phone at
(574) 237-7168.
Dr Khaleelur R Zackariya Sr is licensed to practice in Indiana (license number 01066056A) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306854203.
Physician's Profile
| Full Name | Dr Khaleelur R Zackariya Sr |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 5215 Holycross Parkway, Mishiwaka, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Khaleelur R Zackariya Sr attended and graduated from in
NPI Data:
- NPI Number: 1306854203
- Provider Enumeration Date: 08/04/2006
- Last Update Date: 10/30/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Khaleelur R Zackariya Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306854203 | NPI | - | NPPES |
| 200930470 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208M00000X | Hospitalist | 01066056A (Indiana) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | 01066056A (Indiana) | Primary |
| 207R00000X | Internal Medicine | 036098582 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Khaleelur R Zackariya Sr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Khaleelur R Zackariya Sr, MD
810 Park Pl,
Mishawaka, IN 46545-3520
Ph: (574) 472-6901 | Dr Khaleelur R Zackariya Sr, MD
5215 Holycross Parkway,
Mishiwaka, IN 46545
Ph: (574) 237-7168 |
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