Individual provider Active NPI

Ziad Youssef Fayad, MD

  • Vascular Surgery Physician
  • Mishawaka, IN
National Provider Identifier
1508025867
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01075159A Issued in IN
Practice address
611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465
Phone
(574) 272-5347
Fax
(574) 272-8617
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01075159A IN Primary
Surgery Physician 208600000X 01075159A IN

Addresses

Primary practice location

611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465

Mailing address

611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465

Other identifiers 1

IdentifierTypeStateIssuer
201292160MedicaidIN

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
I20150616001388 IN Practitioner - General SurgeryPractitioner - Vascular Surgery 9739321837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

611 E Douglas Rd
Mishawaka, IN 46545-1465
Phone (574) 335-6060

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Saint Joseph Regional Medical Center - Plymouth Hospital, Plymouth, IN, CCN 150076

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)20

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dialysis Vascular Specialists of Indiana LLC CurrentSince Jul 13, 2023 Accepting new patients
Saint Joseph Regional Medical Center, Inc. CurrentSince Oct 26, 2021 Accepting new patients
X-Ray Consultants Inc CurrentSince Jan 1, 2018 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Vascular Surgery CurrentSince Oct 26, 2021 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2140 N Capitol Ave
Ste 200
Indianapolis, IN 46202

2140 N Capitol Ave
Ste 100
Indianapolis, IN 46202
Phone (317) 644-1404

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

611 E Douglas Rd
Ste 207
Mishawaka, IN 46545
Phone (574) 335-6450

60205 Bodnar Blvd
Mishawaka, IN 46544
Phone (574) 232-2177

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 308
Mishawaka, IN 46545
Phone (574) 236-1888

611 E Douglas Rd
Ste 200
Mishawaka, IN 46545
Phone (574) 272-5347

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

510 W Adams St
Ste 150
Plymouth, IN 46563
Phone (574) 335-3987

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

121 S Saint Louis Blvd
South Bend, IN 46617
Phone (219) 233-3123

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • Direct secure messaging: zfayad@legacy.streamlinemddirect.com
  • Direct secure messaging: zfayad1158647@direct.trinity-health.org

Organizations & group practices 6

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 3

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1508025867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451465",
            "telephone_number": "574-272-5347",
            "fax_number": "574-272-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYAD",
        "first_name": "ZIAD",
        "middle_name": "YOUSSEF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01075159A",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01075159A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201292160",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.