Individual provider Active NPI

Andre McCollough, M.D.

  • Internal Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1316294200
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
281409 Issued in NY
Practice address
4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1414
Phone
(574) 231-6134
Fax
(574) 231-6845
NPI assigned
Aug 9, 2012
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01078115A IN
Internal Medicine Physician 207R00000X 281409 NY Primary
Hospitalist Physician 208M00000X 77876 GA

Addresses

Primary practice location

4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1414

Mailing address

623 Macon St
Apt 3
Brooklyn, NY 11233-1515
Phone (646) 251-8679

Other practice location 1

3125 Transverse Drive
Ruppert Health Center
Toledo, OH 43614-2595
Phone (419) 383-6119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 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

Enrollment IDStateProvider typePAC IDDetails
I20151123001727 NY Practitioner - Internal Medicine 4587964549 Reassigns benefits to 4 organizations
I20200204002840 GA Practitioner - HospitalistPractitioner - Internal Medicine 4587964549 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Toledo College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-2183

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01078115AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Physician Health, P.C. Internal Medicine CurrentSince May 3, 2017 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Jan 5, 2025 Accepting new patients
New York Medical Physician Associates PC Hospitalist CurrentSince Jun 11, 2024 Accepting new patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
New York Medical Physician Associates PC Internal Medicine CurrentSince Jun 11, 2024 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Mar 5, 2024 Accepting new patients
Apogee Medical Group, New York, PC Internal Medicine CurrentSince Sep 3, 2015 Accepting new patients
Cogent Medical Care PC Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Piedmont Rockdale Hospital Inc. Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Cartersville Medical Center LLC Past Accepting new patients
Rural Physicians Group-Pannu PLLC Internal Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

515 Main St
Olean, NY 14760
Phone (716) 373-2600

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 3

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1316294200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 MACON ST",
            "address_2": "APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112331515",
            "telephone_number": "646-251-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451414",
            "telephone_number": "574-231-6134",
            "fax_number": "574-231-6845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Transverse Drive",
            "address_2": "Ruppert Health Center",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-6119",
            "fax_number": "419-383-3234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "ANDRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01078115A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "281409",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "77876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.