Individual provider Active NPI

John B Zimmerer, MD

  • Anesthesiology Physician
  • Logansport, IN
National Provider Identifier
1467461152
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01041629 Issued in IN
Practice address
1101 Michigan Ave
Logansport, IN 46947-1528
Phone
(574) 753-7541
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01041629 IN Primary

Addresses

Primary practice location

1101 Michigan Ave
Logansport, IN 46947-1528

Mailing address

1101 Michigan Ave
Logansport, IN 46947-1528
Phone (574) 753-7541

Other practice location 1

1331 S A St
Elwood, IN 46036-1942
Phone (765) 552-4838

Other identifiers 3

IdentifierTypeStateIssuer
P00448127OtherINRAIL ROAD MEDICARE
000000506214OtherINBLUE CROSS - ANTHEM
200111250MedicaidIN

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
I20070329000400 IN Practitioner - Anesthesiology 6305940495 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Redreef Anesthesia Associates Chartered Indiana LLCGroup PAC ID 7012459647, 36 clinicians

Practice addresses (Care Compare)

1331 S a St
Elwood, IN 46036-1942
Phone (765) 608-3668

4411 Washington Ave
Suite 100
Evansville, IN 47714-0805
Phone (313) 637-9861

600 Grant St
Gary, IN 46402-6001
Phone (888) 851-4642

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Anesthesiology CurrentSince Jan 1, 2023 Accepting new patients
Northstar Anesthesia of Indiana II, LLC Anesthesiology CurrentSince Jan 8, 2015 Accepting new patients
Redreef Anesthesia Associates Chartered Indiana LLC Anesthesiology CurrentSince Apr 25, 2024 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
St. Vincent Medical Group, Inc. Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Northstar Anesthesia of Indiana LLC Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients

Locations

11051 Broadway
Ste B
Crown Point, IN 46307
Phone (219) 308-0193

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1331 S A St
Elwood, IN 46036
Phone (765) 552-4000

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

801 E Lasalle Ave
South Bend, IN 46617
Phone (574) 237-7111

Organizations & group practices 7

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 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1467461152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 S A St",
            "address_purpose": "LOCATION",
            "city": "Elwood",
            "state": "IN",
            "postal_code": "460361942",
            "country_code": "US",
            "telephone_number": "765-552-4838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERER",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01041629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00448127",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - ANTHEM",
            "identifier": "000000506214",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200111250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.