PRIVIA MEDICAL GROUP INDIANA, LLC
NPI 1013912286
Clinic/Center - Multi-Specialty in Elkhart, IN
About Privia Medical Group Indiana, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIVIA MEDICAL GROUP INDIANA, LLC (NPI 1013912286) is a healthcare organization registered as a multi-specialty in Elkhart, Indiana and active in the NPI registry since June 2005. The organization lists Thomas Vandergrift, Chief Executive Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Privia Medical Group Indiana, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
47Medicare enrollment records show 47 clinicians reassign Medicare billing to Privia Medical Group Indiana, LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 33 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 19
Nearest to this location (20)
See all 47Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Privia Medical Group Indiana, LLC's NPI number?
The NPI number for Privia Medical Group Indiana, LLC is 1013912286. It was assigned to this organization in the NPPES registry on June 15, 2005.
Where is Privia Medical Group Indiana, LLC located?
Privia Medical Group Indiana, LLC is located at 303 S Nappanee St, Elkhart, IN 46514. The listed phone number is (574) 296-3200.
What is Privia Medical Group Indiana, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Privia Medical Group Indiana, LLC enrolled in Medicare?
Yes. Privia Medical Group Indiana, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Privia Medical Group Indiana, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 47 clinicians in 19 Medicare specialties reassign their Medicare billing to Privia Medical Group Indiana, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (12), Family Practice (10) and Internal Medicine (6). Of these, 5 practice at this address and 33 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Privia Medical Group Indiana, LLC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Montana and 3 other insurers list Privia Medical Group Indiana, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Privia Medical Group Indiana, LLC was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Privia Medical Group Indiana, Llc · NPI 1013912286
Multi-Specialty organization in Elkhart, Indiana. Organization record, active in the CMS NPPES registry since June 15, 2005.
## Identity
- **NPI:** 1013912286 (Entity type: Organization)
- **Enumerated:** June 15, 2005
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Thomas Vandergrift, CHIEF EXECUTIVE ADMINISTRATOR
## Practice location
- **Address:** 303 S NAPPANEE ST, Elkhart, IN 46514-2066
- **Phone:** (574) 296-3200 · **Fax:** (574) 296-3392
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 47 clinicians in 19 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Family Practice (10), Internal Medicine (6); 5 practice at this address and 33 within 10 miles; [full list](https://npiprofile.com/npi/1013912286/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 17, 2025
- **Other identifiers:** Other 0359310001 (IN); Medicaid 100466600A (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1013912286) · Data from the CMS NPPES public registry.