Individual provider Active NPI

Olivia Papai Price, PA-C

  • Physician Assistant
  • South Bend, IN
National Provider Identifier
1356018022
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003188A Issued in IN
Practice address
6301 University Commons Ste 310
South Bend, IN 46635-1479
Phone
(147) 157-4232
NPI assigned
Aug 30, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003188A IN Primary

Addresses

Primary practice location

6301 University Commons Ste 310
South Bend, IN 46635-1479

Mailing address

6301 University Commons Ste 310
South Bend, IN 46635-1479
Phone (574) 232-1471

Other names 1

  • Olivia Papai Kuczmanski Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909002113 IN Practitioner - Physician Assistant 3678979010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Toledo College of Medicine, 2020
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)

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000

6301 University Commons
South Bend, IN 46635-1416
Phone (574) 234-8161

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003188AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Sep 1, 2021 Accepting new patients
The South Bend Clinic, LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

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 310
South Bend, IN 46635
Phone (574) 232-1471

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

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
  • Direct secure messaging: oprice254798@dulyhealthandcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1356018022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 310",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351479",
            "telephone_number": "574-232-1471",
            "fax_number": "574-239-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS STE 310",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351479",
            "telephone_number": "147-157-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "OLIVIA",
        "middle_name": "PAPAI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003188A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "KUCZMANSKI",
            "middle_name": "PAPAI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.