JOHN WALSH AG-ACNP
NPI 1316427560
Nurse Practitioner - Acute Care in South Bend, IN
About John Walsh Ag-acnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN WALSH AG-ACNP (NPI 1316427560) is an individual acute care provider in South Bend, Indiana, licensed in Indiana (71008427A) and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John Walsh Ag-acnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show John Walsh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
South Bend, IN 46601
- Reassigned Medicare billing, Indiana enrollment
- Medicare enrollment name: Beacon Medical Group Inc
- 734 clinicians in this Medicare group
Bremen, IN 46506
- Reassigned Medicare billing, Indiana enrollment
- 87 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH BEND, IN 46601
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 John Walsh's NPI number?
The NPI number for John Walsh is 1316427560. It was assigned to this individual provider in the NPPES registry on August 17, 2018.
Where is John Walsh located?
John Walsh practices at 621 Memorial Dr Ste 502, South Bend, IN 46601. The listed phone number is (574) 647-5875.
What is John Walsh's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is John Walsh enrolled in Medicare?
Yes. John Walsh is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for John Walsh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Walsh reassigns Medicare benefits to 2 organizations: Memorial Health System, Inc. (South Bend, IN) and Aims, LLC (Bremen, IN). Each 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 John Walsh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for John Walsh was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# John Walsh, AG-ACNP · NPI 1316427560
Acute Care physician in South Bend, Indiana. Individual provider, active in the CMS NPPES registry since August 17, 2018.
## Identity
- **NPI:** 1316427560 (Entity type: Individual)
- **Enumerated:** August 17, 2018
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 71008427A (Indiana)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 621 MEMORIAL DR STE 502, South Bend, IN 46601-1075
- **Phone:** (574) 647-5875 · **Fax:** (574) 647-5878
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Memorial Health System, Inc. (NPI 1073554994, South Bend, IN); Aims, LLC (NPI 1376072785, Bremen, IN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 28, 2023
- **Other identifiers:** Medicaid 300021695 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1316427560) · Data from the CMS NPPES public registry.