GREGORY POULIOT PHD
NPI 1336549328
Psychologist - Clinical in South Bend, IN
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
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Gregory Pouliot reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
South Bend, IN 46601
- Reassigned Medicare billing, Indiana enrollment
- 734 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.
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.
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, INPhysician 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
SOUTH BEND, IN 46601
SOUTH BEND, IN 46601
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 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.
Which organization bills Medicare for Gregory Pouliot's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Pouliot reassigns Medicare benefits to Beacon Medical Group, Inc. (South Bend, IN). The 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 Gregory Pouliot's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gregory Pouliot accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield 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.
# Gregory Pouliot, PHD · NPI 1336549328
Clinical provider in South Bend, Indiana. Individual provider, active in the CMS NPPES registry since August 27, 2014.
## Identity
- **NPI:** 1336549328 (Entity type: Individual)
- **Enumerated:** August 27, 2014
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 20042945A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 714 N MICHIGAN ST, South Bend, IN 46601-1035
- **Phone:** (574) 647-7477 · **Fax:** (574) 647-3655
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Beacon Medical Group, Inc. (NPI 1609828946, South Bend, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** March 31, 2021
- **Other identifiers:** Medicaid 201392530 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1336549328) · Data from the CMS NPPES public registry.