Individual provider Active NPI

Michael Pfeiffer, D.O.

  • Otolaryngology Physician
  • South Bend, IN
National Provider Identifier
1295078228
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
02005370B Issued in IN
Practice address
6301 University Commons Ste 360
South Bend, IN 46635
Phone
(574) 232-4800
NPI assigned
Mar 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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
Otolaryngology Physician 207Y00000X 02005370B IN Primary

Addresses

Primary practice location

6301 University Commons Ste 360
South Bend, IN 46635

Mailing address

6301 University Commons Ste 360
South Bend, IN 46635-3500
Phone (574) 232-4800

Other practice location 1

4190 City Ave
Philadelphia, PA 19131-1626
Phone (215) 871-6693

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
I20180524002341 IN Practitioner - Otolaryngology 6507121449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2013
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)

6301 University Commons
Suite 360
South Bend, IN 46635-3500
Phone (574) 232-4800

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Saint Joseph Regional Medical Center - Plymouth Hospital, Plymouth, IN, CCN 150076
  • Unity Physicians Hospital Hospital, Mishawaka, IN, CCN 150177
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02005370BINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Jun 1, 2020 Accepting new patients
The South Bend Clinic, LLC CurrentSince Jun 1, 2020 Accepting new patients

Locations

303 S Nappanee St
Elkhart, IN 46514

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

6301 University Commons
Ste 230
South Bend, IN 46635
Phone (574) 251-2115

6301 University Commons
Ste 360
South Bend, IN 46635
Phone (574) 232-4800

515 N Lafayette Blvd
South Bend, IN 46601
Phone (219) 232-2037

Interoperability endpoints

  • Direct secure messaging: mpfeiffer254744@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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 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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1295078228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 360",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466353500",
            "telephone_number": "574-232-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 360",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46635",
            "telephone_number": "574-232-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311626",
            "country_code": "US",
            "telephone_number": "215-871-6693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "02005370B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.