Individual provider Active NPI

Mayer Zayan, M.D.

  • Internal Medicine Physician
  • Northbrook, IL
National Provider Identifier
1619064151
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036060803 Issued in IL
Practice address
3605 Woodhead Dr Ste 111
Northbrook, IL 60062-1850
Phone
(800) 564-5270
Fax
(877) 432-7816
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036060803 IL Primary

Addresses

Primary practice location

3605 Woodhead Dr Ste 111
Northbrook, IL 60062-1850

Mailing address

3605 Woodhead Dr Ste 111
Northbrook, IL 60062-1850
Phone (800) 564-5270

Other identifiers 2

IdentifierTypeStateIssuer
036060803MedicaidIL
1619064151MedicaidIL

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
I20031211000463 IL Practitioner - Internal Medicine 7315843166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036060803ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lev Monitoring Solutions Inc Current Accepting new patients
Homecare Docs LLC CurrentSince Jan 1, 2016 Accepting new patients
Zayan Medical Corporation CurrentSince Jul 26, 2016 Accepting new patients
Lev Diagnostics Inc Current Accepting new patients
Health Direction Medical Center, S.C. Internal Medicine PastSince Jul 25, 2014 Accepting new patients
Housecall Professionals Inc PastSince Jul 1, 2017 Accepting new patients
Lake County Physical Therapy LLC Past Accepting new patients
AMC Medical Center, LLC Past Accepting new patients

Locations

3194 Doolittle Dr
Northbrook, IL 60062
Phone (847) 537-5555

3605 Woodhead Dr
Ste 111
Northbrook, IL 60062
Phone (800) 564-5270

1480 Renaissance Dr
Ste 414
Park Ridge, IL 60068
Phone (847) 813-6216

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1619064151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 WOODHEAD DR STE 111",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621850",
            "telephone_number": "800-564-5270",
            "fax_number": "877-432-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 WOODHEAD DR STE 111",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621850",
            "telephone_number": "800-564-5270",
            "fax_number": "877-432-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAYAN",
        "first_name": "MAYER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036060803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036060803",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619064151",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.