Michael James Phend, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01030254A Issued in IN

Practice address

5215 Holy Cross Parkway
Mishawaka, IN 46545-1469

Phone

(574) 237-7168

Fax

(574) 472-6262

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Associated Surgeons and Physicians, LLC

  • Foot & Ankle Surgery Podiatrist
  • Auburn, IN
  • NPI 1649720301
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1992731905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 PARK PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453520",
            "telephone_number": "574-472-6700",
            "fax_number": "574-472-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PARKWAY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-237-7168",
            "fax_number": "574-472-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHEND",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01030254A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01030254A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000626560",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112690",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER - TIN 35-2030653",
            "identifier": "000000705131",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000527516",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Bain Petersen, DPT
• Lauren Rose Peterson
• Cindy Petzke, NURSE PRACTITIONER
• Tracy Jeannine Pfaffenberger, R.D., C.D.
• David P Pflum, D.D.S.
• Sheila Lynne Phillips, FNP
• Phoenix Counseling Services, Incorporated
• Physicians Holistic Health Alliance, LLC
• Physicians Hospital, LLC
• Physiotherapy Associates Inc

• Internal Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.