NPIMap

The South Bend Clinic LLC

A Medicare group practice based in South Bend, IN: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 3779577937), with 212 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
3779577937The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Multi-Specialty - Physician, Part B Supplier - Ambulatory Surgical Center, Part B Supplier - Clinic/Group Practice, Part B Supplier - Independent Clinical Laboratory
Enrolled in
IN, MI
Enrollments
6
Group size
171 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
49In 10 places

Enrollment records 6

Enrollment IDStateProvider typeNPI
O20040412000439 IN Part B Supplier - Clinic/Group Practice 1073680419
O20071025000007 MI Part B Supplier - Clinic/Group Practice 1073680419
O20070720000001 IN Part B Supplier - Ambulatory Surgical Center 1073680419
O20110624000518 IN Part B Supplier - Independent Clinical Laboratory 1073680419
O20100930013481 IN DME Supplier - Multi-Specialty - Physician 1073680419
O20220519000909 IN DME Supplier - Multi-Specialty - Physician 1124791587

NPIs in this group 3

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 212

Page 1 of 3

Clinicians who reassign their Medicare benefits to this group (212) or whom Care Compare lists as members (171).

Sources for this page