Individual provider Active NPI

Gary B Fromm, MD

  • Sleep Disorder Diagnostic Clinic/Center
  • South Bend, IN
National Provider Identifier
1184722076
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
License
01024475A Issued in IN
Practice address
615 N Michigan St
Medical Education Dept Memorial Hospital
South Bend, IN 46601
Phone
(574) 243-4768
Fax
(574) 647-3427
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01024475A IN
Pulmonary Disease Physician 207RP1001X 01024475A IN
Sleep Disorder Diagnostic Clinic/Center 261QS1200X 01024475A IN Primary

Addresses

Primary practice location

615 N Michigan St
Medical Education Dept Memorial Hospital
South Bend, IN 46601

Mailing address

615 N Michigan St
Medical Education Dept Memorial Hospital
South Bend, IN 46601
Phone (574) 243-4768

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
I20050401000163 IN Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 1254391394 Reassigns benefits to 1 organization
Practice locations: South Bend, IN

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Indiana University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-7916

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of South Bend CurrentSince Jun 23, 2009 Accepting new patients
Memorial Hospital of South Bend CurrentSince Jun 23, 2009 Accepting new patients

Locations

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

Organizations & group practices 2

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 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184722076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "address_2": "MEDICAL EDUCATION DEPT MEMORIAL HOSPITAL",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-243-4768",
            "fax_number": "574-647-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "address_2": "MEDICAL EDUCATION DEPT MEMORIAL HOSPITAL",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-243-4768",
            "fax_number": "574-647-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROMM",
        "first_name": "GARY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01024475A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01024475A",
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "IN",
            "license": "01024475A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.