Peri R Stangas, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10002615A Issued in IN

Practice address

6301 University Commons Ste 210
South Bend, IN 46635-1590

Phone

(574) 234-4016

Fax

(574) 239-4607

NPI assigned

Nov 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Midwestern University College of Dental Medicine, Glendale, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medicine of South Bend PCGroup PAC ID 5395659882, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FGJBCD/Endpoint/FGJBCD

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.

• Family Medicine of South Bend PC

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1356432538
  Medicare reassignment Care Compare group

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

• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1043788284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 210",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351590",
            "telephone_number": "574-234-4016",
            "fax_number": "574-239-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 210",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351590",
            "telephone_number": "574-234-4016",
            "fax_number": "574-239-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGAS",
        "first_name": "PERI",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "10002615A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021948",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peri.stangas@fmsb.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6301 University Commons Ste 210",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466351590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaleigh Renee Stafford
• Cheryl Ann Stahl, FNP-BC
• Madelyn Stahl, RPH
• Alec Thomas Staiger, DO
• Alyssa Stair, RBT
• Ronald Stangebye, DDS
• Cynthia Danielle Stanton
• Catherine Stapleford, MSED
• Star Psychiatric Services PC
• Star Psychiatric Services PC

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.