Nicholas J Adams, MD
Individual provider Active NPI Emergency Medicine Physician · Mishawaka, IN
NPI 1578057758 · NPPES record last updated Aug 10, 2022
Key facts
- NPI
- 1578057758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 01087998A (IN)
- Practice address
- 5215 Holy Cross Pkwy # In46545
Mishawaka, IN 46545-1469 - Phone
- (574) 335-5000
- NPI assigned
- Jun 20, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Wayne State University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Interlochen Emergency Group PC
Hawk Emergency Group, P.C.
Practice addresses (Care Compare)
1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000
825 N Ctr Ave
Gaylord, MI 49735-1592
Phone (989) 731-2100
Hospital & facility affiliations
- Munson Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210804002270 | MI | Practitioner - Emergency Medicine | 7810391448 | Reassigns benefits to 3 organizations |
| I20220705001812 | IN | Practitioner - Emergency Medicine | 7810391448 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301116001 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interlochen Emergency Group, P.C. | Emergency Medicine | Current |
Accepting new patients |
| Lake Michigan Emergency Specialists, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Elite Emergency Physicians Inc | Emergency Medicine | Current |
Accepting new patients |
Locations
600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621
5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443
1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181
1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511
72 S State St
Shelby, MI 49455
Phone (231) 728-4601
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- nadams43268@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301116001 | MI | |
| Emergency Medicine Physician | 207P00000X | 01087998A | IN | Yes |
Addresses
Primary practice location
5215 Holy Cross Pkwy # In46545
Mishawaka, IN 46545-1469
Mailing address
600 East Blvd
Elkhart, IN 46514-2483
Phone (574) 523-3161
Other practice location 1
1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 726-3511
Other providers in Mishawaka, IN
- Nicholas Abel
- Delivac Akosua Serwaa Aboagye
- Above All Chiropractic Center, LLC
- Ann Belen Acevedo
- Active Day in, Inc.
- Adec Inc
- Adec Inc
- Adec Inc
- Adec Inc
- Michelle Adgalanis
All providers in Mishawaka, IN · Emergency Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.