The South Bend Clinic LLC
NPI 1073680419ActiveOrganization· Clinic/Center· South Bend, IN
Clinic/Center in South Bend, Indiana, registered in NPPES in November 2006. The authorized official on file is Paul J. Meyer, Executive Director. Medicare paid $1,468,258 for services to 991 patients in 2024.
Overview
| NPI | 1073680419 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 29, 2006 |
| Last updated in NPPES | Jul 10, 2024 |
| Certified by provider | Jul 10, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | — |
| Clinic/Center, Ambulatory Surgical | 261QA1903X | — | IN |
| Clinical Medical Laboratory | 291U00000X | 15D0357414 | IN |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Multi-Specialty - Physician (IN); Part B Supplier - Ambulatory Surgical Center (IN); Part B Supplier - Clinic/Group Practice (IN); Part B Supplier - Independent Clinical Laboratory (IN); Part B Supplier - Clinic/Group Practice (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 991 |
|---|---|
| Services billed | 1,478 across 214 procedure codes |
| Paid by Medicare | $1,468,258 |
Other Clinic/Center providers in South Bend
- 1063419026
- 1255236006
- 1255412342
- 1497306310
- 1538257167
- 1548658651
- 1770242380
- 1851742928
- 1952071110
- 1962914119