Individual provider Active NPI

Eugene Michael Feltman, DDS., MSD

  • Endodontics
  • South Bend, IN
National Provider Identifier
1003988940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6494 Issued in IN
Practice address
225 N Notre Dame Ave
Suite 2
South Bend, IN 46617-2839
Phone
(574) 232-5866
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 6494 IN Primary

Addresses

Primary practice location

225 N Notre Dame Ave
Suite 2
South Bend, IN 46617-2839

Mailing address

225 N Notre Dame Ave
Suite 2
South Bend, IN 46617-2839
Phone (574) 232-5866

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000369 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466639935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6494INMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Risser Endodontics P.C. Endodontics Past Accepting new patients

Organizations & group practices 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003988940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N NOTRE DAME AVE",
            "address_2": "SUITE 2",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172839",
            "telephone_number": "574-232-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N NOTRE DAME AVE",
            "address_2": "SUITE 2",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172839",
            "telephone_number": "574-232-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTMAN",
        "first_name": "EUGENE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS., MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "6494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.