SOUTH BEND CLINIC
NPI 1073680419
Clinic/Center in South Bend, IN
About South Bend Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH BEND CLINIC (NPI 1073680419) is a healthcare organization registered as a clinic/center in South Bend, Indiana and active in the NPI registry since November 2006. The organization holds 5 active CLIA laboratory certificates, maintains a secondary practice location in South Bend, and lists Paul J Meyer, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Secondary Practice Location 1
Other Identifiers 1
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)
South Bend Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
212Medicare enrollment records show 212 clinicians reassign Medicare billing to South Bend Clinic, which bills Medicare for the services they deliver. Of these, 48 practice at this address and 125 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 33
Nearest to this location (20)
See all 212Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 5
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 15D0681940
South Bend Clinic LLC Dmg/ Dermatology · South Bend, INCertificate of Waiver 15D1106971
South Bend Clinic Surgicenter The · South Bend, INCertificate for Provider-Performed Microscopy Procedures (PPMP) 15D2240222
South Bend Clinic - Eddy Street · South Bend, INCertificate of Waiver 15D2002931
South Bend Clinic, LLP Dba, The Pediatric Associates Of Michiana · South Bend, INCertificate for Provider-Performed Microscopy Procedures (PPMP) 15D0357399
South Bend Clinic, LLP, The Dba Ob Gyn Assoc Of Northern In · South Bend, INAreas of Expertise CMS Part B claims 23
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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 The South Bend Clinic LLC's NPI number?
The NPI number for The South Bend Clinic LLC is 1073680419. It was assigned to this organization in the NPPES registry on November 29, 2006. The provider is also known as South Bend Clinic.
Where is The South Bend Clinic LLC located?
The South Bend Clinic LLC is located at 211 N Eddy St, South Bend, IN 46617. The listed phone number is (574) 299-2450.
What is The South Bend Clinic LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is The South Bend Clinic LLC enrolled in Medicare?
Yes. The South Bend Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through The South Bend Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 212 clinicians in 33 Medicare specialties reassign their Medicare billing to The South Bend Clinic 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 Diagnostic Radiology (37), Nurse Practitioner (34) and Family Practice (25). Of these, 48 practice at this address and 125 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does The South Bend Clinic LLC hold CLIA laboratory certificates?
Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does The South Bend Clinic 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 4 other insurers list The South Bend Clinic 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 The South Bend Clinic LLC was last updated on July 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# South Bend Clinic · NPI 1073680419
Clinic/Center organization in South Bend, Indiana. Organization record, active in the CMS NPPES registry since November 29, 2006.
## Identity
- **NPI:** 1073680419 (Entity type: Organization)
- **Enumerated:** November 29, 2006
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** The South Bend Clinic Llc
- **Organization subpart:** No
- **Authorized official:** Paul Meyer, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 211 N EDDY ST, South Bend, IN 46617-2808
- **Phone:** (574) 299-2450 · **Fax:** (574) 299-2415
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 212 clinicians in 33 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (37), Nurse Practitioner (34), Family Practice (25); 48 practice at this address and 125 within 10 miles; [full list](https://npiprofile.com/npi/1073680419/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 10, 2024
- **Other identifiers:** Medicaid 100442630 (IN)
- **CLIA laboratory certificates:** 5 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073680419) · Data from the CMS NPPES public registry.