Individual provider Active NPI

Mallikarjun Patta, MD

  • Psychiatry Physician
  • Crown Point, IN
National Provider Identifier
1164499554
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01057540A Issued in IN
Practice address
12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone
(219) 852-1524
Fax
(219) 933-2288
NPI assigned
Mar 3, 2006
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01057540A IN Primary

Addresses

Primary practice location

12750 Saint Francis Dr
Crown Point, IN 46307-0264

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

11106 Birch Lake Dr
Granger, IN 46530-6032
Phone (574) 247-0110

Other identifiers 1

IdentifierTypeStateIssuer
200428170AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpatta171467@Direct.FranciscanAlliance.org Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000122 IN Practitioner - Psychiatry 2365472313 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bend Psychiatry LLCGroup PAC ID 1951440643, 3 clinicians

Practice addresses (Care Compare)

1800 N Oak Dr
Plymouth, IN 46563-3406
Phone (574) 303-5375

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01057540AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Feb 14, 2025 Accepting new patients
Aims, LLC Psychiatry CurrentSince Mar 4, 2018 Accepting new patients
South Bend Psychiatry LLC Psychiatry CurrentSince Nov 1, 2009 Accepting new patients
Franciscan Physician Network CurrentSince Feb 14, 2025 Accepting new patients
Allied Mental Health Associates, Inc. Past Accepting new patients
Compass Health, Inc Past Accepting new patients
Allied Mental Health Consultants LLC Past Accepting new patients
HHC Indiana Inc. Past Accepting new patients

Locations

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

308 W Market St
Crawfordsvlle, IN 47933
Phone (765) 359-1660

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

1012 W Indiana St
Kouts, IN 46347
Phone (219) 766-2999

301 W Homer St
Michigan City, IN 46360
Phone (219) 877-1033

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1800 N Oak Dr
Plymouth, IN 46563
Phone (574) 303-5375

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

403 E Madison St
South Bend, IN 46617
Phone (574) 234-0061

Interoperability endpoints

  • Direct secure messaging: mpatta1158715@direct.trinity-health.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1164499554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SAINT FRANCIS DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-852-1524",
            "fax_number": "219-933-2288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11106 Birch Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465306032",
            "country_code": "US",
            "telephone_number": "574-247-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTA",
        "first_name": "MALLIKARJUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01057540A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200428170A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatta171467@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12750 Saint Francis Dr",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463070264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.