NPIMap

Individual provider Active NPI

Raymond Zimmerman, M.D.

  • Family Medicine Physician
  • Merrillville, IN
National Provider Identifier
1386602100
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01035397A Issued in IN
Practice address
8777 Broadway
Suite a
Merrillville, IN 46410-6693
Phone
(219) 756-0960
Fax
(219) 756-0961
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01035397A IN Primary
Family Medicine Physician 207Q00000X 036-081831 IL

Addresses

Primary practice location

8777 Broadway
Suite a
Merrillville, IN 46410-6693

Mailing address

8777 Broadway
Suite a
Merrillville, IN 46410-6693
Phone (219) 756-0960

Other identifiers 6

IdentifierTypeStateIssuer
036081831MedicaidIL
200152060MedicaidIN
0222075OtherILBLUE CROSS GROUP NUMBER
3631498336019001OtherILCDPG HFS PAYEE ID
P00700171OtherILRR MEDICARE
363149833OtherILTAX IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050511000796 IN Practitioner - Family Practice 9335189042 Reassigns benefits to 1 organization
I20061117000430 IL Practitioner - Family PracticePractitioner - Emergency Medicine 9335189042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Indiana University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians
Suresh D. Reddy, MD, LLCGroup PAC ID 4284604612, 3 clinicians

Practice addresses (Care Compare)

425 Sand Creek Dr
Chesterton, IN 46304-1589

8777 Broadway
Suite a
Merrillville, IN 46410-6694
Phone (219) 756-0960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.29 of 100Reported as individual
Quality
63.55
Improvement activities
40
Cost
76.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-081831ILMDFamily Medicine Physician
01035397AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suresh D. Reddy, MD, LLC Family Medicine CurrentSince May 1, 2006 Accepting new patients
Central Dupage Hospital Association CurrentSince Jan 1, 1999 Accepting new patients
Central Dupage Hospital Association CurrentSince Jan 1, 1999 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients

Locations

2900 Foxfield Rd
St Charles, IL 60174
Phone (630) 377-6500

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

8777 Broadway
Ste A
Merrillville, IN 46410
Phone (219) 756-0960

Interoperability endpoints

  • Direct secure messaging: rzimmerman18146@themethodisthospitals.direct-ci.com
  • Direct secure messaging: rzimmerman83160@direct.franciscanalliance.org

Organizations & group practices 5

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 10

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1386602100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8777 BROADWAY",
            "address_2": "SUITE A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106693",
            "telephone_number": "219-756-0960",
            "fax_number": "219-756-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8777 BROADWAY",
            "address_2": "SUITE A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106693",
            "telephone_number": "219-756-0960",
            "fax_number": "219-756-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "RAYMOND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01035397A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-081831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081831",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200152060",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00700171",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "363149833",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.