Timothy W Noveroske, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

01038790A Issued in IN

Practice address

621 Memorial Dr
South Bend, IN 46601-1064

Phone

(574) 236-1888

Fax

(574) 236-1887

NPI assigned

Dec 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

General Surgery

Education

University of Michigan Medical School, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
• Unity Physicians Hospital Hospital, Mishawaka, IN, CCN 150177

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tnoveroske254616@dulyhealthandcare.direct-ci.com
• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD

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

• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation
• United Surgeons, LLC

  dba Unity Physicians Hospital

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1518197011
  Care Compare affiliation

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1285611442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011064",
            "telephone_number": "574-236-1888",
            "fax_number": "574-236-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011064",
            "telephone_number": "574-236-1888",
            "fax_number": "574-236-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVEROSKE",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01038790A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Indiana Optometrists, PC
• Northern Indiana Orthopaedic Specialty Associates, PC (Northern Indiana Hand & Wrist Center)
• Northern Indiana Rehabilitation Medicine, Inc.
• Erica K Northern
• Matthew Darl Norton, DO
• Christine Nowak, M.ED
• Edward Daniel Nusbaum, M.D.
• Rodolfo Enrique Nussbaum Gonzalez
• Nwi Hospitalists LLC
• Azubike Nwokedi, NP

• Vascular Surgery Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.