NPIMap

Individual provider Active NPI

Thomas Anthony Pechin II, M. D.

  • Family Medicine Physician
  • Shipshewana, IN
National Provider Identifier
1982675864
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01033810 Issued in IN
Practice address
450 E Country LN
Shipshewana, IN 46565-8568
Phone
(260) 768-4141
Fax
(260) 768-7295
NPI assigned
Jan 30, 2006
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01033810 IN Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 01033810 IN

Addresses

Primary practice location

450 E Country LN
Shipshewana, IN 46565-8568

Mailing address

450 E Country LN
Shipshewana, IN 46565-8568
Phone (260) 768-4141

Other identifiers 1

IdentifierTypeStateIssuer
100359970MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomas.pechin.ii@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000814 IN Practitioner - Family PracticePractitioner - Geriatric Medicine 5991773285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Indiana University School of Medicine, 1984
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)

2014 S Main St
Goshen, IN 46526-5235

2824 Elkhart Rd
Goshen, IN 46526-1014
Phone (574) 535-1700

2832 Elkhart Rd
Goshen, IN 46526-1014
Phone (574) 537-0219

450 E Country LN
Shipshewana, IN 46565-8568
Phone (260) 768-4141

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions40
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01033810INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Family Medicine CurrentSince Oct 1, 2005 Accepting new patients
Goshen Health System Inc CurrentSince Oct 1, 2005 Accepting new patients

Locations

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

450 E Country Ln
Shipshewana, IN 46565
Phone (260) 768-4141

916 Myrtle St
Sturgis, MI 49091
Phone (269) 651-7824

Interoperability endpoints

  • Direct secure messaging: thomas.pechin.ii@goshenhealthdirect.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avalon VillageLigonier, IN, CCN 155286 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2018
Feb 10, 2026
Life Care Center of LagrangeLagrange, IN, CCN 155343 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2010
Oct 1, 2010

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1982675864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E COUNTRY LN",
            "city": "SHIPSHEWANA",
            "state": "IN",
            "postal_code": "465658568",
            "telephone_number": "260-768-4141",
            "fax_number": "260-768-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E COUNTRY LN",
            "city": "SHIPSHEWANA",
            "state": "IN",
            "postal_code": "465658568",
            "telephone_number": "260-768-4141",
            "fax_number": "260-768-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHIN",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "name_suffix": "II",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01033810",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01033810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100359970",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.pechin.ii@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "450 E Country Ln",
            "city": "Shipshewana",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465658568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shipshewana, IN

Sources for this page

Verify at the official NPI Registry.