NATHAN D'EMILIO DO
NPI 1407640642
Student in an Organized Health Care Education/Training Program in Mishawaka, IN

Q: What is Nathan D'emilio's NPI number?

The NPI number for Nathan D'emilio is 1407640642. It was assigned to this individual provider in the NPPES registry on April 4, 2025.

Q: What is Nathan D'emilio's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nathan D'emilio was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.

Active since April 04, 2025PECOS Enrolled

611 E DOUGLAS RD STE 407, MISHAWAKA, IN 46545(574) 335-6500 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nathan D'emilio Do NPPES

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

NATHAN D'EMILIO DO (NPI 1407640642) is an individual student in an organized health care education/training program in Mishawaka, Indiana and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407640642

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameNATHAN D'EMILIOCredential: DO

Location Address611 E DOUGLAS RD STE 407Mishawaka, IN 46545-1468

Mailing Address611 E Douglas Rd Ste 407Mishawaka, IN 46545-1468

Phone(574) 335-6500

Sole ProprietorNo

Enumeration DateApril 4, 2025

NPPES CertifiedApril 4, 2025

✔ NPI 1407640642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

611 E DOUGLAS RD STE 407, Mishawaka, IN 46545

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nathan D'emilio Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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. ALLYSON BRIANNE BRUNET SLUSSER DO

Student in an Organized Health Care Education/Training Program