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GREGORY POULIOT PHD
NPI 1336549328
Psychologist - Clinical in South Bend, IN

Active since August 27, 2014PECOS EnrolledAccepts Medicare Assignment
714 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-7477(574) 647-3655 Get Directions Write a Review

NPPES record last updated: March 31, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 31, 2021, Nov 2, 2016 (2 updates tracked since 2016).

About Gregory Pouliot Phd NPPES

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

GREGORY POULIOT PHD (NPI 1336549328) is an individual clinical provider in South Bend, Indiana, licensed in Indiana (20042945A) and active in the NPI registry since August 2014. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of South Bend, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1336549328
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameGREGORY POULIOTCredential: PHD
Location Address714 N MICHIGAN STSouth Bend, IN 46601-1035
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Phone(574) 647-7477
Fax(574) 647-3655
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateAugust 27, 2014
Last NPPES UpdateMarch 31, 20212 updates tracked since enumeration
NPPES CertifiedMarch 31, 2021
✔ NPI 1336549328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IN · 20042945A
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
714 N MICHIGAN ST, South Bend, IN 46601
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Other Identifiers 1

Medicaid201392530IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Gregory Pouliot 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 ID5890083646
PECOS Enrollment IDI20161011000133
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

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.

Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
19 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Of South Bend

Acute Care Hospitals · South Bend, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150058
Location615 N Michigan StSouth Bend, IN 46601 · St. Joseph County
Emergency services Birthing friendly

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.

New Patient
$161.76 typical visit price
range $53.07 – $161.76
Typical copayment $40.44 (range $13.26 – $40.44)
Most-billed visit code 99205
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 20

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

DR. DAVID HENRY TALARICO MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ABIGAIL LEIGH REESE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
DALE ALAN PATTERSON M.D.
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
MATTHEW T. DUPRE MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
RICHARD J. WARD MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
VICTORIA ANN BAWEL MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ISAAC D HATTON MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7913
LAURA LAWRENCE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477

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 Gregory Pouliot's NPI number?

The NPI number for Gregory Pouliot is 1336549328. It was assigned to this individual provider in the NPPES registry on August 27, 2014.

Where is Gregory Pouliot located?

Gregory Pouliot practices at 714 N Michigan St, South Bend, IN 46601. The listed phone number is (574) 647-7477.

What is Gregory Pouliot's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Gregory Pouliot enrolled in Medicare?

Yes. Gregory Pouliot is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gregory Pouliot accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Gregory Pouliot 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.

Is Gregory Pouliot affiliated with any hospitals?

According to CMS data, Gregory Pouliot is affiliated with Memorial Hospital Of South Bend.

When was this NPI record last updated?

The NPPES record for Gregory Pouliot was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.