NPIMap

Individual provider Active NPI

Diane Helen Zug, MD

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1578596227
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
6830 Villagreen VW
Rockford, IL 61107-5639
Phone
(815) 282-1339
Fax
(815) 282-1298
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

6830 Villagreen VW
Rockford, IL 61107-5639

Mailing address

6830 Villagreen VW
Rockford, IL 61107-5639
Phone (815) 282-1339

Other identifiers 2

IdentifierTypeStateIssuer
P00434019OtherILRR MEDICARE PTAN NUMBER
CC5050OtherILRR MEDICARE GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710002281 CO Practitioner - Family Practice 1557365558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Health Physicians Colorado LLCGroup PAC ID 8921273038, 278 clinicians

Practice addresses (Care Compare)

303 Colland Dr
Fort Collins, CO 80525-4205
Phone (970) 821-3031

Hospital & facility affiliations

  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126
  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Banner North Co Medical Center - Loveland Campus Hospital, Loveland, CO, CCN 060030
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 23, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Mar 17, 2020 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 23, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Mar 17, 2020 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

303 Colland Dr
Fort Collins, CO 80525
Phone (970) 461-8031

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1578596227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 VILLAGREEN VW",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075639",
            "telephone_number": "815-282-1339",
            "fax_number": "815-282-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 VILLAGREEN VW",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075639",
            "telephone_number": "815-282-1339",
            "fax_number": "815-282-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUG",
        "first_name": "DIANE",
        "middle_name": "HELEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "P00434019",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CC5050",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.