Michiana Gastroenterology, Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MICHIANA GASTROENTEROLOGY, INC

Practice address

17501 Generations Dr
South Bend, IN 46635-1589

Phone

(574) 234-0049

Fax

(574) 251-2861

NPI assigned

Jun 27, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Melissa A Walker

Title

Administrator

Phone

(574) 234-0049

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Ann Buford, NP

  • Family Nurse Practitioner
  • South Bend, IN
  • NPI 1841969060
  Medicare reassignment Care Compare group NPD
• Michael Alan Manbeck, M.D.

  • Gastroenterology Physician
  • South Bend, IN
  • NPI 1649272725
  Medicare reassignment Care Compare group NPD
• John Glenn Mathis, M.D.

  • Gastroenterology Physician
  • South Bend, IN
  • NPI 1427051341
  Medicare reassignment Care Compare group NPD
• Mary Jo Morey, FNP-BC

  • Family Nurse Practitioner
  • South Bend, IN
  • NPI 1972500874
  Medicare reassignment Care Compare group NPD
• Ashley B. O'Bannon, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Dyer, IN
  • NPI 1629248711
  Medicare reassignment Care Compare group NPD
• Pankaj A Patel, M.D.

  • Gastroenterology Physician
  • South Bend, IN
  • NPI 1124022082
  Medicare reassignment Care Compare group NPD
• Ravi J Patel, M.D.

  • Gastroenterology Physician
  • South Bend, IN
  • NPI 1750607354
  Medicare reassignment Care Compare group NPD
• Sonali Shukla, MD

  • Anatomic Pathology Physician
  • La Porte, IN
  • NPI 1003862228
  Medicare reassignment Care Compare group NPD
• Thomas R Vanderheyden Jr., D.O.

  • Internal Medicine Physician
  • South Bend, IN
  • NPI 1528222387
  Medicare reassignment Care Compare group NPD
• Briana R Weidler-Edholm, NP

  • Nurse Practitioner
  • South Bend, IN
  • NPI 1144882069
  Medicare reassignment Care Compare group NPD
• Desiree Dian Williams, FNP-BC

  • Family Nurse Practitioner
  • Crown Point, IN
  • NPI 1548502495
  Medicare reassignment Care Compare group NPD
• Hassam Shah

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1376103028

  IN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821094525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17501 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351589",
            "telephone_number": "574-234-0049",
            "fax_number": "574-251-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17501 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351589",
            "telephone_number": "574-234-0049",
            "fax_number": "574-251-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIANA GASTROENTEROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "574-234-0049",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100222490A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maritza Andreina Michalak, DMD
• Lisa Michaud Glenn, OTR
• Michiana Eye Center LLC
• Michiana Family Dental LLC
• Michiana Foot Care Clinic L.L.C
• Michiana Hearing Care Center, P.C.
• Michiana Home Services, Inc. (Always Best Care Michiana - Home Health)
• Michiana Home Services, Inc. (Always Best Care-Michiana)
• Michiana Nutrition and Diabetes Education LLC
• Michiana Oral &Maxillofacial Surgery LLC

• Gastroenterology Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.