Individual provider Active NPI

Patrick Marty Korman, OD

  • Optometrist
  • Mishawaka, IN
National Provider Identifier
1851969786
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3734 Issued in MN
Practice address
4330 Edison Lakes Pkwy Ste a
Mishawaka, IN 46545-1446
Phone
(574) 271-0120
Fax
(574) 273-4108
NPI assigned
Jun 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3734 MN Primary

Addresses

Primary practice location

4330 Edison Lakes Pkwy Ste a
Mishawaka, IN 46545-1446

Mailing address

4330 Edison Lakes Pkwy Ste a
Mishawaka, IN 46545-1446
Phone (574) 271-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220124000158 MN Practitioner - Optometry 9133511223 Reassigns benefits to 1 organization
I20240726001005 IN Practitioner - Optometry 9133511223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grossnickle Eye Center IncGroup PAC ID 7810897758, 12 clinicians

Practice addresses (Care Compare)

2251 Dubois Dr
Warsaw, IN 46580-3212
Phone (574) 269-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Marshall CurrentSince Oct 16, 2021 Accepting new patients
Grossnickle Eye Center, Inc. CurrentSince Jul 15, 2024 Accepting new patients
Avera Marshall Optometrist CurrentSince Oct 16, 2021 Accepting new patients
Grossnickle Eye Center, Inc. Current Accepting new patients
Avera Marshall Current Accepting new patients
Grossnickle Eye Center, Inc. CurrentSince Jul 15, 2024 Accepting new patients
Avera Marshall Past Accepting new patients

Locations

1510 Osolo Rd
Elkhart, IN 46514
Phone (574) 266-6100

4330 Edison Lakes Pkwy
Ste A
Mishawaka, IN 46545
Phone (574) 269-2777

4330 Edison Lakes Pkwy
Mishawaka, IN 46545

2855 Miller Dr
Ste 121
Plymouth, IN 46563
Phone (574) 647-1600

2251 Dubois Dr
Warsaw, IN 46580
Phone (574) 269-2777

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

500 E Bridge St
Redwood Falls, MN 56283
Phone (507) 637-5715

900 E Cook St
Redwood Falls, MN 56283
Phone (507) 637-5715

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/mi-gecenter

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1851969786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 EDISON LAKES PKWY STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451446",
            "telephone_number": "574-271-0120",
            "fax_number": "574-273-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 EDISON LAKES PKWY STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451446",
            "telephone_number": "574-271-0120",
            "fax_number": "574-273-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORMAN",
        "first_name": "PATRICK",
        "middle_name": "MARTY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.