Patrick J Viscardi, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

01048709A Issued in IN

Practice address

611 E Douglas Rd Ste 108
Mishawaka, IN 46545-1464

Phone

(574) 968-9100

Fax

(574) 968-3517

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

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

Plastic and Reconstructive Surgery

Education

University of Rochester School of Medicine and Dentistry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrick.viscardi@goshenhealthdirect.com
• Direct secure messaging: pviscardi1158542@direct.trinity-health.org

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.

• Goshen Health System Inc

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1194772293
  Medicare reassignment Care Compare group NPD
• The Centre PC

  • Plastic Surgery Physician
  • Mishawaka, IN
  • NPI 1568533990
  Medicare reassignment NPD
• Goshen Health System Inc

  • Radiology Clinic/Center
  • Goshen, IN
  • NPI 1588190284
  NPD
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  NPD
• The Centre LLC

  • Ambulatory Surgical Clinic/Center
  • Mishawaka, IN
  • NPI 1144380163
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1801893268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD",
            "address_2": "#108",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-968-9100",
            "fax_number": "574-968-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 108",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-968-9100",
            "fax_number": "574-968-3517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 High Park Ave",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465264810",
            "country_code": "US",
            "telephone_number": "574-364-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISCARDI",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "IN",
            "license": "01048709A",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IN",
            "license": "01048709A",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IN",
            "license": "01048709A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200168380",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pviscardi@thecentrepc.com",
            "affiliation": "N",
            "endpointDescription": "The Centre, PC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 E Douglas Rd Ste 108",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465451464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.viscardi@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "200 High Park Ave",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raay Vergamini
• Mary Vernon
• Gina Elaina Verteramo, FNP-BC
• Vertical Plus MRI of America, LLC
• Gabriela Vettorello
• Vision Value, LLC
• Visionary Surgery Center, LLC
• Tanya Christina Vogt, PA-C
• Austin William Vonasek, DPM
• Julie T. Voor, M.A.,CCC-SLP

• Plastic Surgery Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Plastic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.