NPIMap

Individual provider Active NPI

James Dyer, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
National Provider Identifier
1124125513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01051578 Issued in IN
Practice address
530 N. Lafayette Blvd.
South Bend, IN 46601-1098
Phone
(574) 234-4176
Fax
(574) 234-1561
NPI assigned
Sep 20, 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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01051578 IN Primary

Addresses

Primary practice location

530 N. Lafayette Blvd.
South Bend, IN 46601-1098

Mailing address

530 N. Lafayette Blvd.
South Bend, IN 46601-1098
Phone (574) 234-4176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL, MI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110113000102 IN Practitioner - Pathology 5991994576 Reassigns benefits to 2 organizations
I20151028000542 IL Practitioner - Pathology 5991994576 Reassigns benefits to 1 organization
I20230925003587 MI Practitioner - Pathology 5991994576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bend Medical Foundation IncGroup PAC ID 3971411349, shared by 2 NPIs, 14 clinicians
Legacy Path LLCGroup PAC ID 5890237960, 16 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 266-7231

3355 Douglas Rd
South Bend, IN 46635-1779
Phone (574) 234-4176

530 N Lafayette Blvd
South Bend, IN 46601-1004
Phone (574) 234-4176

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051578INMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Path LLC Anatomic Pathology & Clinical Pathology CurrentSince Jun 25, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Aug 28, 2015 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Oct 20, 1999 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Oct 20, 1999 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Aug 28, 2015 Accepting new patients

Locations

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1000 Health Center Dr
Ste 305
Mattoon, IL 61938
Phone (217) 258-4186

3355 Douglas Rd
South Bend, IN 46635
Phone (574) 234-4176

530 N Lafayette Blvd
South Bend, IN 46601
Phone (574) 204-5206

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124125513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N. LAFAYETTE BLVD.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011098",
            "telephone_number": "574-234-4176",
            "fax_number": "574-234-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N. LAFAYETTE BLVD.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011098",
            "telephone_number": "574-234-4176",
            "fax_number": "574-234-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01051578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.