KHALEELUR R. ZACKARIYA, SR. MD – NPI #1306854203
Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
KHALEELUR ZACKARIYA, SR. is a physician located in MISHAWAKA, IN. NPPES has assigned the NPI number 1306854203 to KHALEELUR ZACKARIYA, SR. on August 04, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine
The NPI profile was last updated on Oct 30, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KHALEELUR ZACKARIYA, SR. below.
NPI Profile for
KHALEELUR R. ZACKARIYA, SR.
(about 20 years ago)
MISHAWAKA, IN 46545 Phone: (574) 237-7168 Fax: (574) 472-6262
MISHAWAKA, IN 46545-3520 Phone: (574) 472-6901 Fax: (574) 472-6262
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for KHALEELUR ZACKARIYA, SR.
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| medicaid | IN | 200930470 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207RA0401X - Internal Medicine / Addiction Medicine (Primary) |
IN | 01066056A |
| 208M00000X - Hospitalist |
IN | 01066056A |
| 207R00000X - Internal Medicine |
IL | 036098582 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
KHALEELUR ZACKARIYA, SR. is affiliated with the following medical group(s):
- HOSPITAL
- SAINT JOSEPH REGIONAL MEDICAL CENTER5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545 - SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH1915 LAKE AVE
PLYMOUTH, IN 46563
- SAINT JOSEPH REGIONAL MEDICAL CENTER5215 HOLY CROSS PKWY
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