Mary Regina Feeks Lacoursiere, DO

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

02007852A Issued in IN

Practice address

615 N Michigan St 5TH FL
South Bend, IN 46601-1033

Phone

(574) 647-7275

Fax

(574) 647-3696

NPI assigned

Jun 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Philadelphia College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group NPD
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Medical Group Critical Kids

  • Pediatric Critical Care Medicine Physician
  • South Bend, IN
  • NPI 1467408237
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1659864387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST 5TH FL",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-7275",
            "fax_number": "574-647-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACOURSIERE",
        "first_name": "MARY",
        "middle_name": "REGINA FEEKS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IN",
            "license": "02007852A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300093262",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Labcorp Indiana Inc
• Labcorp Indiana Inc
• Laboratory Corporation of America
• Laboratory Corporation of America Holdings
• Jennifer L. Lackman-Chuppe, MD
• Richard Lacoursiere
• Erin T. Lacourt, LAC
• Carrie Lacrone, MSW
• Alison R Ladson
• Ibrahim Hussein Ali Lafi, MD

• Pediatric Critical Care Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Pediatric Critical Care Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.

Verify at the official NPI Registry.