Matthew Pazderka

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01099563A Issued in IN

Practice address

765 S Michigan St
South Bend, IN 46601-3101

Phone

(574) 235-7990

Fax

(574) 847-7201

NPI assigned

Mar 28, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

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 2

Specialty

Family Practice

Education

University of Nebraska College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Immediate Care CenterGroup PAC ID 2264423771, shared by 2 NPIs, 23 clinicians

Indiana Health Centers IncGroup PAC ID 3971599473, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Lakeland Hospitals St Joseph Hospital Home health agency, Benton Harbor, MI, CCN 237163
• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpazderka1271322@epic00.shdirect.org

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.

• Indiana Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1598776742
  Medicare reassignment Care Compare group
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Cassopolis, MI
  • NPI 1982677548

  Family Medicine

  Medicare reassignment NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1881492338
  NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Niles, MI
  • NPI 1760802912
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  • Home Health Agency
  • Benton Harbor, MI
  • NPI 1912094525
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1275995219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CASTLEWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501946",
            "telephone_number": "317-576-1335",
            "fax_number": "317-343-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013101",
            "telephone_number": "574-235-7990",
            "fax_number": "574-847-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZDERKA",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01099563A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301117376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Patterson, FNP-C
• Paul B. Glass DDS PC
• Paul Michael McLeod DDS, Inc.
• William Edward Paul, DDS
• Yaquiris Paulino, RBT
• Jessica Peachey, LMHC
• Michelle Lynn Pearson, M.D.
• Richard B Pearson
• Daniel J Peck, MSW
• Thomas Pedavoli, DDS

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.