Individual provider Active NPI

Steven J Zelman, M.D.

  • Nephrology Physician
  • Mount Vernon, IL
National Provider Identifier
1487618765
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036068228 Issued in IL
Practice address
416 N 12TH St
Mount Vernon, IL 62864-4314
Phone
(618) 244-4850
Fax
(618) 244-7985
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036068228 IL Primary

Addresses

Primary practice location

416 N 12TH St
Mount Vernon, IL 62864-4314

Mailing address

416 N 12TH St
Mount Vernon, IL 62864-4314
Phone (618) 244-4850

Other identifiers 1

IdentifierTypeStateIssuer
4123105OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110209000946 IL Practitioner - NephrologyPractitioner - Internal Medicine 4082658844

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1487618765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644314",
            "telephone_number": "618-244-4850",
            "fax_number": "618-244-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644314",
            "telephone_number": "618-244-4850",
            "fax_number": "618-244-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELMAN",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036068228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4123105",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.