SOUTH BEND CLINIC
NPI 1073680419
Clinic/Center in South Bend, IN
NPI Status: Active since November 29, 2006
Contact Information
211 N EDDY ST
SOUTH BEND, IN
ZIP 46617
Phone: (574) 299-2450
Fax: (574) 299-2415
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 15D2240222
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-17-2027
About SOUTH BEND CLINIC
This page provides the complete NPI Profile along with additional information for South Bend Clinic, a provider established in South Bend, Indiana operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1073680419 assigned on November 2006. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's other name is South Bend Clinic. The authorized official of this NPI record is Mr. Paul J Meyer (Executive Director)
- NPI
- 1073680419
- Provider Legal Name
- THE SOUTH BEND CLINIC LLC
- Other Organization Name
- SOUTH BEND CLINIC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 211 N EDDY ST SOUTH BEND, IN 46617
- Location Phone
- (574) 299-2450
- Location Fax
- (574) 299-2415
- Mailing Address
- 6301 UNIVERSITY COMMONS STE 230 SOUTH BEND, IN 46635
- Mailing Phone
- (574) 251-2115
- Mailing Fax
- (574) 299-2415
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-29-2006
- Last Update Date
- 07-10-2024
- Code Navigator
Location Map
Secondary Locations
- 6301 University Commons Ste 230
South Bend, IN 46635
(574) 251-2115
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | (IN) |
| 2 | 291U00000X | Laboratories | Clinical Medical Laboratory | 15D0357414 (IN) |
| 3 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
- Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100442630 | MEDICAID (05) | IN |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Biopsy of large bowel using a flexible endoscope
Biopsy of lining of uterus and/or removal of polyp using an endoscope
Blood test, comprehensive group of blood chemicals
Colorectal cancer screening; colonoscopy on individual at high risk
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Diagnostic exam of large bowel using a flexible endoscope
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection of substance into lower spine canal using imaging guidance
Insertion of guide wire with dilation of esophagus using a flexible endoscope
Insertion of needle into vein for collection of blood sample
Removal of cataract with insertion of prosthetic lens
Removal of gallbladder using an endoscope
Removal of nasal air passage under lining tissue
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery
Removal of polyps or growths of large bowel using an endoscope with mechanical snare
Repair of groin hernia (5 years or older)
Replacement of thigh bone and hip joint with prosthesis
Reshaping of nasal cartilage
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
This service was performed 74 times for 74 patientsA biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
This service was performed 46 times for 46 patientsThis procedure involves using a thin, flexible tool (endoscope) to examine and possibly remove a small tissue sample from the inner layer of your uterus. It may also involve removing a growth. It helps to identify any issues and plan the right treatment.
This service was performed 12 times for 12 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 14 times for 13 patientsColorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
This service was performed 89 times for 89 patientsColorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
This service was performed 54 times for 54 patientsThis procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
This service was performed 41 times for 41 patientsThis procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
This service was performed 53 times for 40 patientsThis procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
This service was performed 13 times for 12 patientsThis is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.
This service was performed 23 times for 23 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 20 times for 20 patientsThis is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
This service was performed 149 times for 92 patientsThis procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
This service was performed 20 times for 20 patientsThis procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.
This service was performed 14 times for 12 patientsThis procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
This service was performed 12 times for 12 patientsThis procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
This service was performed 88 times for 88 patientsRepair of a groin hernia is a procedure aimed at fixing an abnormal bulge that can occur in the area between your abdomen and thigh. This condition happens when tissue pushes through a weak spot in your lower abdominal wall. The repair procedure returns this tissue back to its proper place.
This service was performed 30 times for 29 patientsThis procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.
This service was performed 23 times for 22 patientsReshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.
This service was performed 13 times for 13 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2240222
- Facility Type
- Physician Office
- Certificate Effective Date
- October 18, 2025
- Certificate Expiration Date
- October 17, 2027
- Laboratory Director
- LOUIS CAVADINI
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to South Bend Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1073680419, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SOUTH BEND, IN 46617
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073680419, enumerated as an "organization" on November 29, 2006.
The provider is located at 211 N EDDY ST SOUTH BEND, IN 46617 and the phone number is (574) 299-2450.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.