NPIMap

Individual provider Active NPI

Laura Michelle Griesinger, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
National Provider Identifier
1235659905
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01087647A Issued in IN
Practice address
530 N Lafayette Blvd
South Bend, IN 46601-1004
Phone
(574) 234-4176
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301111891 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01087647A IN Primary

Addresses

Primary practice location

530 N Lafayette Blvd
South Bend, IN 46601-1004

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220804003411 IN Practitioner - Pathology 5496027336 Reassigns benefits to 2 organizations
I20230906002792 MI Practitioner - Pathology 5496027336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Vermont College of Medicine, 2017
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
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Saint Joseph Regional Medical Center - Plymouth Hospital, Plymouth, IN, CCN 150076
  • 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
01087647AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients
Legacy Path LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 17, 2024 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

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 3

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 8

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1235659905",
    "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": "466011004",
            "telephone_number": "574-234-4176"
        },
        {
            "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": "466011004",
            "telephone_number": "574-234-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESINGER",
        "first_name": "LAURA",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301111891",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01087647A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.