Active NPI
Andre McCollough, M.D.
- Internal Medicine Physician
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 281409
- 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, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 01078115A | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph's Physician Health, P.C. | Internal Medicine | Current | Accepting new patients |
| Phoebe Physician Group, Inc | Current | Accepting new patients | |
| New York Medical Physician Associates PC | Hospitalist | Current | Accepting new patients |
| Piedmont Hospitalist Physicians LLC | Internal Medicine | Current | Accepting new patients |
| New York Medical Physician Associates PC | Internal Medicine | Current | Accepting new patients |
| Cogent Healthcare of Georgia PC | Internal Medicine | Current | Accepting new patients |
| Apogee Medical Group, New York, PC | Internal Medicine | Current | Accepting new patients |
| Cogent Medical Care PC | Internal Medicine | Current | 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.
-
- Family Medicine Physician
- Stockbridge, GA
- NPI 1548219660
Internal Medicine
-
- Internal Medicine Physician
- Macon, GA
- NPI 1609827823
-
- Internal Medicine Physician
- East Patchogue, NY
- NPI 1912941238
-
- Hospitalist Physician
- Poughkeepsie, NY
- NPI 1578316501
Internal Medicine
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
-
- Anesthesiology Physician
- Troy, NY
- NPI 1154376770
Internal Medicine
-
- Psychologist
- Atlanta, GA
- NPI 1316959869
-
- Hospitalist Physician
- Margaretville, NY
- NPI 1528869203
-
dba Cartersville Medical Center
- General Acute Care Hospital
- Cartersville, GA
- NPI 1780638833
-
- General Acute Care Hospital
- Suffern, NY
- NPI 1346213469
-
- General Acute Care Hospital
- Conyers, GA
- NPI 1306355680
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Cartersville Medical Center
- General Acute Care Hospital
- Cartersville, GA
- NPI 1780638833
-
- General Acute Care Hospital
- Newnan, GA
- NPI 1134133002
-
- General Acute Care Hospital
- Conyers, GA
- NPI 1306355680
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.