DR. LUIZ C PANTALENA FILHO MD, PHD
NPI 1225321722
Dermatology in South Bend, IN

Active since May 17, 2011PECOS EnrolledAccepts Medicare Assignment
4322 S LAFAYETTE BLVD, SOUTH BEND, IN 46614(574) 391-1111(574) 859-5040 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 11, 2025, Mar 20, 2025, Mar 31, 2021 (3 updates tracked since 2021).

About Dr. Luiz C Pantalena Filho Md, Phd NPPES

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

DR. LUIZ C PANTALENA FILHO MD, PHD (NPI 1225321722) is an individual dermatology provider in South Bend, Indiana, licensed in Indiana (01073773A) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS and is a graduate of Stanford University School Of Medicine (2010).

NPPES Registry Identity

NPI1225321722
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameDR. LUIZ C PANTALENA FILHOCredential: MD, PHD
Location Address4322 S LAFAYETTE BLVDSouth Bend, IN 46614-2518
Mailing Address4322 S Lafayette BlvdSouth Bend, IN 46614-2518 · (574) 391-1111 · Fax (574) 859-5040
Fax(574) 859-5040
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 2010
Enumeration DateMay 17, 2011
Last NPPES UpdateApril 11, 20253 updates tracked since enumeration
NPPES CertifiedApril 11, 2025
NPI 1225321722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in IN · 01073773A
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License 01073773A (IN)
4322 S LAFAYETTE BLVD, South Bend, IN 46614

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Luiz C Pantalena Filho Md, Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406176460
PECOS Enrollment IDI20150515000232
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.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311
This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.
265 services214 patients
Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032
This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.
195 services176 patients
Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks 17313
This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.
130 services98 patients
Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052
This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.
70 services66 patients
Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602
This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.
66 services63 patients
Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262
This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.
57 services51 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46614 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
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
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

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

Dermatology
4322 S LAFAYETTE BLVD
SOUTH BEND, IN 46614

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225321722, enumerated as an "individual" on May 17, 2011.

The provider is located at 4322 S LAFAYETTE BLVD SOUTH BEND, IN 46614 and the phone number is (574) 391-1111.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.