NPIMap

Individual provider Active NPI

Zachary Paul Luchtefeld, D.O.

  • Family Medicine Physician
  • Maryville, IL
National Provider Identifier
1194107573
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036145117 Issued in IL
Practice address
2401 S Center St
Maryville, IL 62062-5401
Phone
(618) 344-3046
Fax
(618) 344-5284
NPI assigned
Jun 22, 2015
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2015018601 MO
Family Medicine Physician 207Q00000X 036145117 IL Primary

Addresses

Primary practice location

2401 S Center St
Maryville, IL 62062-5401

Mailing address

2401 S Center St
Maryville, IL 62062-5401
Phone (618) 344-3046

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zluchtefeld214126@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180524000559 IL Practitioner - Family Practice 7618275579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

2401 S Ctr St
Maryville, IL 62062-5401
Phone (618) 344-3046

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jul 1, 2018 Accepting new patients
SJL Health Systems Inc CurrentSince Jul 1, 2018 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

2401 S Center St
Maryville, IL 62062
Phone (618) 344-3046

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Springfield, IL 62704
Phone (217) 523-5406

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1194107573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625401",
            "telephone_number": "618-344-3046",
            "fax_number": "618-344-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625401",
            "telephone_number": "618-344-3046",
            "fax_number": "618-344-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCHTEFELD",
        "first_name": "ZACHARY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2015018601",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036145117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zluchtefeld214126@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2401 S Center St",
            "city": "Maryville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620625401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.