Dr Khaleelur R Zackariya Sr, MD | |
5215 Holycross Parkway, Mishiwaka, IN 46545 | |
(574) 237-7168 | |
(574) 472-6262 |
Full Name | Dr Khaleelur R Zackariya Sr |
---|---|
Gender | Male |
Speciality | Hospitalist |
Experience | 31 Years |
Location | 5215 Holycross Parkway, Mishiwaka, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306854203 | NPI | - | NPPES |
200930470 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036098582 (Illinois) | Secondary |
207RA0401X | Internal Medicine - Addiction Medicine | 01066056A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Saint Joseph Regional Medical Center | Mishawaka, IN | Hospital |
Saint Joseph Regional Medical Center - Plymouth | Plymouth, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Hospitalist Medicine Physicians Of Indiana Llc | 7719119965 | 27 |
Entity Name | Sound Physicians Of Indiana, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528311149 PECOS PAC ID: 4981841780 Enrollment ID: O20130515000624 |
Entity Name | Northwest Hospitalist Physicians, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023448321 PECOS PAC ID: 0244397693 Enrollment ID: O20140205000078 |
Entity Name | Hospitalist Medicine Physicians Of Indiana Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720416555 PECOS PAC ID: 7719119965 Enrollment ID: O20140422001842 |
Entity Name | Hospitalist Medicine Physicians Of Ohio - Westerville, Professional C |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215416367 PECOS PAC ID: 7911259809 Enrollment ID: O20210222001857 |
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 |