Individual provider Active NPI

Chemanoor U Zachariah, MD

  • Internal Medicine Physician
  • Tracy, CA
National Provider Identifier
1780655951
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A30629 Issued in CA
Practice address
130 W 11TH St
Suite D
Tracy, CA 95376-3935
Phone
(209) 833-0886
Fax
(209) 835-6614
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 A30629 CA Primary

Addresses

Primary practice location

130 W 11TH St
Suite D
Tracy, CA 95376-3935

Mailing address

130 W 11TH St
Suite D
Tracy, CA 95376-3935
Phone (209) 833-0886

Other identifiers 1

IdentifierTypeStateIssuer
00A306291MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100719000250 CA Practitioner - Internal Medicine 7810029451 Practice locations: Tracy, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 W 11TH St
Suite D
Tracy, CA 95376-3935
Phone (209) 833-0886

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Salida, CA, CCN 057695
  • Sutter Tracy Community Hospital Hospital, Tracy, CA, CCN 050313
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
  • Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118
  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A30629CAMDInternal Medicine Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: czachariah61292@hisp.ehr.sutterhealth.org

Hospital & facility affiliations 5

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1780655951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W 11TH ST",
            "address_2": "SUITE D",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763935",
            "telephone_number": "209-833-0886",
            "fax_number": "209-835-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 11TH ST",
            "address_2": "SUITE D",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763935",
            "telephone_number": "209-833-0886",
            "fax_number": "209-835-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "CHEMANOOR",
        "middle_name": "U",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A30629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A306291",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.