Individual provider Active NPI

Andrej Zajac, M.D.

  • Radiation Oncology Physician
  • Munster, IN
National Provider Identifier
1316929623
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
01040122 Issued in IN
Practice address
901 Macarthur Blvd
Radiation Oncology Department
Munster, IN 46321-2901
Phone
(219) 836-6390
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 01040122 IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Radiation Oncology Department
Munster, IN 46321-2901

Mailing address

9201 Calumet Ave
Munster, IN 46321-2807
Phone (219) 836-9024

Other identifiers 1

IdentifierTypeStateIssuer
100327210MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080808000696 IN Practitioner - Radiation Oncology 1557331303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Jefferson Medical College of Thomas Jefferson University, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 947-6685

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
  • Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01040122INMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Jan 1, 2016 Accepting new patients

Locations

10191 Broadway
Crown Point, IN 46307
Phone (219) 661-6100

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

300 W 61st Ave
Hobart, IN 46342
Phone (219) 942-5745

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

Organizations & group practices 1

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

Hospital & facility affiliations 5

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1316929623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212807",
            "telephone_number": "219-836-9024",
            "fax_number": "219-836-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "address_2": "RADIATION ONCOLOGY DEPARTMENT",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "ANDREJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01040122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100327210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.