Individual provider Active NPI

Neil James Sink, M.D.

  • Obstetrics & Gynecology Physician
  • Mishawaka, IN
National Provider Identifier
1659509065
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01079255A Issued in IN
Practice address
611 E Douglas Rd Ste 408
Mishawaka, IN 46545-1468
Phone
(574) 335-6440
Fax
(574) 335-0806
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X 01079255A IN Primary
Obstetrics & Gynecology Physician 207V00000X 29080 NE

Addresses

Primary practice location

611 E Douglas Rd Ste 408
Mishawaka, IN 46545-1468

Mailing address

707 E Cedar St
Suite 200
South Bend, IN 46617-2057
Phone (574) 335-8707

Other identifiers 3

IdentifierTypeStateIssuer
300006551MedicaidIN
IN1041052OtherINMEDICARE
000001119328OtherINBCBS

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
I20171011000323 IN Practitioner - Obstetrics/Gynecology 3173741949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

611 E Douglas Rd
408 OBGYN
Mishawaka, IN 46545-1468
Phone (574) 335-6440

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29080NEMDObstetrics & Gynecology Physician

Organizations & group practices 1

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 2

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1659509065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E CEDAR ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172057",
            "telephone_number": "574-335-8707",
            "fax_number": "574-335-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 408",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-6440",
            "fax_number": "574-335-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINK",
        "first_name": "NEIL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01079255A",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "29080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006551",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IN1041052",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000001119328",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.