NPIMap

Individual provider Active NPI

Irshath Mohamed Zackariya, PT, DPT

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1497196547
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05006954A Issued in IN
Practice address
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone
(574) 247-9441
Fax
(574) 247-9442
NPI assigned
Jul 16, 2013
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501009243 MI
Physical Therapist 225100000X 05006954A IN Primary

Addresses

Primary practice location

53880 Carmichael Dr
South Bend, IN 46635-1567

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407

Other practice location 1

60160 Bodnar Blvd
Mishawaka, IN 46544-9338
Phone (574) 247-9441

Other practice location 2

5230 Beck Dr Ste 7
Elkhart, IN 46516-9059
Phone (574) 247-9441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
64.48
Promoting interoperability
96
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Spine & Joint Center P.C. Physical Therapist Current Accepting new patients
Michigan Spine & Joint Center P.C. CurrentSince Mar 1, 2015 Accepting new patients
Physical Therapy Group Inc. Physical Therapist PastSince Jun 1, 2003 Accepting new patients
Fajr Physical Therapy Clinic LLC Physical Therapist PastSince Jan 19, 2025 Accepting new patients

Locations

32500 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 725-3100

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1497196547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60160 Bodnar Blvd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465449338",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5230 Beck Dr Ste 7",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465169059",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZACKARIYA",
        "first_name": "IRSHATH",
        "middle_name": "MOHAMED",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-16",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009243",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006954A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.