NPIMap

Individual provider Active NPI

Nicole Anest, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
National Provider Identifier
1255438644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01059756A 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
Female
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 01059756A 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, 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
I20050119000252 IN Practitioner - Pathology 9638128481 Reassigns benefits to 3 organizations
I20230817002079 MI Practitioner - Pathology 9638128481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Nebraska College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bend Medical Foundation Inc 14 clinicians
Legacy Path LLC 16 clinicians
The South Bend Clinic LLC 171 clinicians

Practice addresses (Care Compare)

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

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

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

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Three Rivers Health Hospital, Three Rivers, MI, CCN 230015

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Path LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 17, 2024 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Sep 8, 2004 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Sep 8, 2004 Accepting new patients
The South Bend Clinic, LLC CurrentSince Dec 1, 2019 Accepting new patients
The South Bend Clinic LLC CurrentSince Dec 1, 2019 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

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

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

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255438644",
    "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": "ANEST",
        "first_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "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": "01059756A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.