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DR. JACK S. BARTOSZEK D.O.
NPI 1093714818
Family Medicine - Geriatric Medicine in Mishawaka, IN

Active since July 14, 2005PECOS Enrolled
615 FULMER RD, MISHAWAKA, IN 46544(574) 252-3085(574) 252-5906 Get Directions Write a Review

NPPES record last updated: September 20, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack S. Bartoszek D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK S. BARTOSZEK D.O. (NPI 1093714818) is an individual geriatric medicine provider in Mishawaka, Indiana, licensed in Indiana (02001105) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093714818
Entity TypeIndividualMale
Primary Taxonomy207QG0300X
Provider Legal NameDR. JACK S. BARTOSZEKCredential: D.O.
Location Address615 FULMER RDMishawaka, IN 46544-6911
Mailing Address4455 Edison Lakes Pkwy, Unity Medical Surgical HospitalMishawaka, IN 46545-1442 · (574) 252-3085 · Fax (574) 252-5906
Phone(574) 252-3085
Fax(574) 252-5906
Sole ProprietorNo
Enumeration DateJuly 14, 2005
Last NPPES UpdateSeptember 20, 2013
✔ NPI 1093714818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in IN · 02001105
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
615 FULMER RD, Mishawaka, IN 46544
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Other Identifiers 7

Medicare PIN184640EIN
Medicare PIN080093853 RR MED.IN
Medicare UPINE33584
Medicaid100335800AIN
Other000000109340IN · Anthem Number
OtherOA41009MI · Bcbsm
Medicare PINN99060005MI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack S. Bartoszek D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46544 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MICHELE M SMITH FNP-BC
Nurse Practitioner (Family)
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 252-2663
I-SPINE, LLC
Orthopaedic Surgery
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 252-2663
ROBERT B MCCLURE DO
Family Medicine
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 271-2558
DR. V DURGA MADHUSUDANA MURTHY RAO DO
Orthopaedic Surgery
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 252-2663
MICHIANA PRIMARY CARE LLC
Family Medicine
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 252-3085
MRS. KATHERINE REVAH GUY L.M.H.C.,L.A.C.,M.S.
Counselor (Mental Health)
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 274-1162
LINDA S HOLCOMB MSN, FNP-C
Nurse Practitioner (Family)
615 FULMER RD
MISHAWAKA, IN 46544
St. Joseph County (574) 252-3085

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 Jack Bartoszek's NPI number?

The NPI number for Jack Bartoszek is 1093714818. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Jack Bartoszek located?

Jack Bartoszek practices at 615 Fulmer Rd, Mishawaka, IN 46544. The listed phone number is (574) 252-3085.

What is Jack Bartoszek's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Jack Bartoszek enrolled in Medicare?

Yes. Jack Bartoszek is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Bartoszek was last updated on September 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.