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DR. KHALEELUR R ZACKARIYA SR. MD
NPI 1306854203
Internal Medicine - Addiction Medicine in Mishiwaka, IN

Active since August 04, 2006PECOS EnrolledAccepts Medicare Assignment
5215 HOLYCROSS PARKWAY, MISHIWAKA, IN 46545(574) 237-7168(574) 472-6262 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Khaleelur R Zackariya Sr. Md NPPES

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

DR. KHALEELUR R ZACKARIYA SR. MD (NPI 1306854203) is an individual addiction medicine provider in Mishiwaka, Indiana, licensed in Indiana (01066056A) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1306854203
Entity TypeIndividualMale
Primary Taxonomy207RA0401X
Provider Legal NameDR. KHALEELUR R ZACKARIYA SR.Credential: MD
Location Address5215 HOLYCROSS PARKWAYMishiwaka, IN 46545
Mailing Address810 Park PlMishawaka, IN 46545-3520 · (574) 472-6901 · Fax (574) 472-6262
Phone(574) 237-7168
Fax(574) 472-6262
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateAugust 4, 2006
Last NPPES UpdateOctober 30, 2024
NPPES CertifiedOctober 30, 2024
✔ NPI 1306854203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
License✔ Licensed in IN · 01066056A
Definition
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 036098582 (IL)
Also ListedHospitalistTaxonomy 208M00000X · License 01066056A (IN)
5215 HOLYCROSS PARKWAY, Mishiwaka, IN 46545
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Other Identifiers 1

Medicaid200930470IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Khaleelur R Zackariya Sr. Md 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.

PECOS PAC ID3779649207
PECOS Enrollment IDI20090306000358
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.

Areas of Expertise CMS Part B claims 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
844 services298 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
284 services273 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
163 services159 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
83 services55 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
30 services30 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150012
Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County
Emergency services Birthing friendly

Indiana University Health

Acute Care Hospitals · Indianapolis, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150056
Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County
Emergency services Birthing friendly

Saint Joseph Regional Medical Center - Plymouth

Acute Care Hospitals · Plymouth, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150076
Location1915 Lake AvePlymouth, IN 46563 · Marshall County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46545 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
80%212 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
2 suppliers12 claims12 services$52.29 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers22 claims22 services$13.22 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers25 claims25 services$85.67 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Khaleelur Zackariya's NPI number?

The NPI number for Khaleelur Zackariya is 1306854203. It was assigned to this individual provider in the NPPES registry on August 4, 2006.

Where is Khaleelur Zackariya located?

Khaleelur Zackariya practices at 5215 Holycross Parkway, Mishiwaka, IN 46545. The listed phone number is (574) 237-7168.

What is Khaleelur Zackariya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Is Khaleelur Zackariya enrolled in Medicare?

Yes. Khaleelur Zackariya 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.

What insurance does Khaleelur Zackariya accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Khaleelur Zackariya 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 Khaleelur Zackariya affiliated with any hospitals?

According to CMS data, Khaleelur Zackariya is affiliated with Saint Joseph Regional Medical Center, Indiana University Health and Saint Joseph Regional Medical Center - Plymouth.

When was this NPI record last updated?

The NPPES record for Khaleelur Zackariya was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.