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DOUGLAS DEAN DOCTOR M.D.
NPI 1376598938
Family Medicine in South Bend, IN

Active since May 23, 2006PECOS Enrolled
17321 STATE ROAD 23, SOUTH BEND, IN 46635(574) 335-8400(574) 335-0796 Get Directions Write a Review

NPPES record last updated: January 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 22, 2021, May 10, 2021, Sep 14, 2016 (3 updates tracked since 2016).

About Douglas Dean Doctor M.d. NPPES

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

DOUGLAS DEAN DOCTOR M.D. (NPI 1376598938) is an individual family medicine provider in South Bend, Indiana, licensed in Indiana (01036380) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Regional Medical Center, and maintains a secondary practice location in Mishawaka.

NPPES Registry Identity

NPI1376598938
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDOUGLAS DEAN DOCTORCredential: M.D.
Location Address17321 STATE ROAD 23South Bend, IN 46635-1531
Mailing Address707 E Cedar St, Ste 200South Bend, IN 46617-4207
Phone(574) 335-8400
Fax(574) 335-0796
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1986
Enumeration DateMay 23, 2006
Last NPPES UpdateJanuary 8, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2024
✔ NPI 1376598938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01036380
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
17321 STATE ROAD 23, South Bend, IN 46635
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Secondary Practice Location 1

Location 1231 W Day RdMishawaka, IN 46545-1401 · Phone (574) 335-8445 · Fax (574) 335-0846

Other Identifiers 3

Other000000215746IN · Bcbs
Other000000579960IN · Bcbs
Medicaid100205190AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Douglas Dean Doctor M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5597812230
PECOS Enrollment IDI20090415000073
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 7

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.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
435 services222 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
132 services132 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
84 services84 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
76 services71 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
30 services30 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
29 services29 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Joseph Regional Medical Center

Acute Care Hospitals · Mishawaka, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150012
Location5215 Holy Cross PkwyMishawaka, IN 46545 · St. Joseph County
Emergency services Birthing friendly

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 46635 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.

Referred Medical Equipment & Supplies CMS DME claims 13

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers44 claims103 services$5.90 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers18 claims23 services$1.05 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers15 claims15 services$36.10 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers11 claims11 services$83.75 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers11 claims27 services$33.57 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers14 claims14 services$19.64 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

ROBERT HAYS M.D.
Family Medicine
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400
ROBERT PRESTON KING M.D.
Family Medicine
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400
SUSAN LYNN CONN NP
Nurse Practitioner (Family)
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400

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 Douglas Doctor's NPI number?

The NPI number for Douglas Doctor is 1376598938. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Douglas Doctor located?

Douglas Doctor practices at 17321 State Road 23, South Bend, IN 46635. The listed phone number is (574) 335-8400.

What is Douglas Doctor's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Doctor enrolled in Medicare?

Yes. Douglas Doctor is registered in the Medicare PECOS enrollment system.

What insurance does Douglas Doctor accept?

Health plans from CareSource list Douglas Doctor 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 Douglas Doctor affiliated with any hospitals?

According to CMS data, Douglas Doctor is affiliated with Saint Joseph Regional Medical Center and Memorial Hospital Of South Bend.

When was this NPI record last updated?

The NPPES record for Douglas Doctor was last updated on January 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.