Charles Paul Zakutansky, FNP-C
Individual provider Active NPI General Practice Physician · Highland, IN
NPI 1316626146 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1316626146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 71014116A (IN)
- Practice address
- 9030 Cline Ave
Highland, IN 46322-2204 - Phone
- (219) 750-9497
- NPI assigned
- Jul 18, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Housecall Doctors. P.C.
Practice addresses (Care Compare)
9030 Cline Ave
Highland, IN 46322-2204
Phone (219) 750-9497
Hospital & facility affiliations
- Elara Caring
- At Home Quality Care
- Franciscan Home Care
- Accentcare Home Health of Indiana
- Assured Home Healthcare Inc
- St Mary Medical Center Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 61.32 of 100
- Quality
- 48.21
- Promoting interoperability
- 21
- Improvement activities
- 40
- Cost
- 55.35
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231002001698 | IN | Practitioner - Nurse Practitioner | 1355795873 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71014116A | IN | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Housecall Doctors. P.C. | Current |
Accepting new patients | |
| Housecall Doctors PC | Past | Accepting new patients |
Locations
9030 Cline Ave
Highland, IN 46322
Phone (219) 750-9474
8300 Broadway
Ste D1
Merrillville, IN 46410
Phone (219) 750-9497
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 71014116A | IN | Yes |
Addresses
Primary practice location
9030 Cline Ave
Highland, IN 46322-2204
Mailing address
2025 Cardinal Dr
Wheatfield, IN 46392-7361
Phone (219) 241-6945
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F04230288 | Other | AMERICAN ACADEMY OF NURSE PRACTITIONERS | |
| 28245123A | Other | IN | INDIANA NURSING BOARD |
Other providers in Highland, IN
- Dae-Il Yu
- Richard Yu
- Osama Adnan Zaghmout
- Emily Zahora
- Syeda Batool Fatima Zaidi
- Mark Thomas Zaranski
- Hector R Zavala
- Geraldine Zeni Gallardo
- Andrea Zepeda
All providers in Highland, IN · General Practice Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.