Individual provider Active NPI

Drew Schmucker, MD

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1912311887
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11017905A Issued in IN
Practice address
621 Memorial Dr
South Bend, IN 46601-1063
Phone
(574) 400-4550
Fax
(574) 400-4551
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11017905A IN Primary

Addresses

Primary practice location

621 Memorial Dr
South Bend, IN 46601-1063

Mailing address

714 N Michigan St
South Bend, IN 46601-1035

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drew.schmucker@healthlinc.directbygreenway.com Direct

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
I20210106001446 IN Practitioner - Family Practice 7012132756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

621 Memorial Dr
Suite 402
South Bend, IN 46601-1074
Phone (574) 400-4550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11017905AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince Dec 5, 2020 Accepting new patients
Healthlinc, Inc CurrentSince Dec 5, 2020 Accepting new patients

Locations

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

621 Memorial Dr
Ste 402
South Bend, IN 46601
Phone (574) 232-4800

621 Memorial Dr
South Bend, IN 46601
Phone (574) 236-1888

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

1960 Northside Blvd
South Bend, IN 46615
Phone (574) 231-7228

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

Interoperability endpoints

  • Direct secure messaging: drew.schmucker@healthlinc.directbygreenway.com

Organizations & group practices 3

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1912311887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-400-4550",
            "fax_number": "574-400-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUCKER",
        "first_name": "DREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11017905A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drew.schmucker@healthlinc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "621 Memorial Dr",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.