Individual provider Active NPI

John A Huchko, M.D.

  • Anesthesiology Physician
  • South Bend, IN
National Provider Identifier
1770560575
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01056886A Issued in IN
Practice address
416 E Monroe St
Suite 200
South Bend, IN 46601-2371
Phone
(574) 232-8119
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01056886A IN Primary

Addresses

Primary practice location

416 E Monroe St
Suite 200
South Bend, IN 46601-2371

Mailing address

416 E Monroe St
Suite 200
South Bend, IN 46601-2371
Phone (574) 232-8119

Other identifiers 1

IdentifierTypeStateIssuer
200239860MedicaidIN

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
I20101108000088 IN Practitioner - Anesthesiology 9234324096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Anesthesiologists IncGroup PAC ID 6800837980, 91 clinicians

Practice addresses (Care Compare)

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone (317) 528-5000

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiologists, Inc. Anesthesiology CurrentSince Jul 1, 2017 Accepting new patients

Locations

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

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

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 3

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1770560575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012371",
            "telephone_number": "574-232-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012371",
            "telephone_number": "574-232-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCHKO",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01056886A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200239860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.