PULASKI MEMORIAL HOSPITAL
NPI 1528626652
General Practice in Knox, IN

Active since June 04, 2019CLIA 15D2170744 · Waiver

NPPES record last updated: December 10, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 10, 2024, Mar 13, 2020, Jun 4, 2019 (3 updates tracked since 2019).

About Pulaski Memorial Hospital NPPES

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

PULASKI MEMORIAL HOSPITAL (NPI 1528626652) is a healthcare organization registered as a general practice in Knox, Indiana and active in the NPI registry since June 2019. The organization holds a CLIA Waiver certificate valid through August 18, 2027 and lists Gregg Malott, Cfo, as its authorized official.

NPPES Registry Identity

NPI1528626652
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePULASKI MEMORIAL HOSPITAL
Location Address2 S PEARL STKnox, IN 46534-1416
Mailing AddressPo Box 279Winamac, IN 46996-0279 · (574) 946-2100
Organization SubpartYes
Authorized OfficialGregg MalottCfo · (574) 946-2103
Enumeration DateJune 4, 2019
Last NPPES UpdateDecember 10, 20243 updates tracked since enumeration
NPPES CertifiedDecember 10, 2024
✔ NPI 1528626652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X
2 S PEARL ST, Knox, IN 46534

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pulaski Memorial Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIndianaEnrollment IDO20040402000963Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

63

Medicare enrollment records show 63 clinicians reassign Medicare billing to Pulaski Memorial Hospital, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 15

Nurse Practitioner22
Diagnostic Radiology12
Family Practice8
Clinical Social Worker5
General Surgery4
Orthopedic Surgery2
Podiatry2
Emergency Medicine1
7 other specialties7

Nearest to this location (20)

See all 63
Nurse Practitioner
NPI 1790251239
2 S PEARL ST
Knox, IN 46534
(574) 207-5050
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1023269040
104 E CULVER RD STE 102
Knox, IN 46534
(574) 772-7918
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1104423326
2 S PEARL ST
Knox, IN 46534
(574) 207-5050
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1215525100
414 LANE ST
North Judson, IN 46366
(574) 896-4325
✔ PECOS✔ Accepts Medicare9.6 mi
Nurse Practitioner
NPI 1295061141
414 LANE ST
North Judson, IN 46366
(574) 896-4325
✔ PECOS9.6 mi
Nurse Practitioner
NPI 1568248946
6194 E MAIN ST
Monterey, IN 46960
(574) 542-2552
✔ PECOS✔ Accepts Medicare12 mi
Clinical Social Worker
NPI 1407047186
118 N SALLY DR
Winamac, IN 46996
(574) 946-4233
✔ PECOS✔ Accepts Medicare16 mi
Family Practice
NPI 1699773994
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS16 mi
General Surgery
NPI 1790813442
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Nurse Practitioner
NPI 1730686114
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Family Practice
NPI 1730272857
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Family Practice
NPI 1902366412
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Clinical Social Worker
NPI 1770839797
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Nurse Practitioner
NPI 1851862585
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
General Surgery
NPI 1912388414
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2194
✔ PECOS✔ Accepts Medicare16 mi
Podiatry
NPI 1659860096
616 E 13TH ST
Winamac, IN 46996
(574) 946-2135
✔ PECOS✔ Accepts Medicare16 mi
Mental Health Counselor
NPI 1740103761
540 HOSPITAL DR
Winamac, IN 46996
(574) 946-2143
✔ PECOS16 mi
Diagnostic Radiology
NPI 1255356085
1007 LINCOLNWAY
Laporte, IN 46350
(219) 326-2305
✔ PECOS✔ Accepts Medicare23 mi
Orthopedic Surgery
NPI 1689682072
401 NEWPORT BLVD
La Porte, IN 46350
(219) 326-2663
✔ PECOS✔ Accepts Medicare23 mi
Internal Medicine
NPI 1568665917
1551 SOUTH STURDY ROAD
Valparaiso, IN 46383
(219) 252-3401
✔ PECOS✔ Accepts Medicare24 mi
See all 63 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2170744

Pulaski Memorial Hospital Knox Medical Clinic · Knox, IN
Active · expires Aug 18, 2027
CLIA Number15D2170744
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 19, 2025
Certificate Expiration DateAugust 18, 2027
Laboratory DirectorJennifer Biesiadecki
Laboratory Phone(574) 207-5050
Laboratory LocationPulaski Memorial Hospital Knox Medical Clinic2 S Pearl Street, Knox, IN 46534
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Pulaski Memorial Hospital's NPI number?

The NPI number for Pulaski Memorial Hospital is 1528626652. It was assigned to this organization in the NPPES registry on June 4, 2019.

Where is Pulaski Memorial Hospital located?

Pulaski Memorial Hospital is located at 2 S Pearl St, Knox, IN 46534. The listed phone number is (574) 207-5050.

What is Pulaski Memorial Hospital's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Pulaski Memorial Hospital enrolled in Medicare?

Yes. Pulaski Memorial Hospital is registered in the Medicare PECOS enrollment system.

When is Pulaski Memorial Hospital's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Pulaski Memorial Hospital?

According to the CMS Revalidation Reassignment List (October 2026 release), 63 clinicians in 15 Medicare specialties reassign their Medicare billing to Pulaski Memorial Hospital. A 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 the clinician's services. The largest specialties are Nurse Practitioner (22), Diagnostic Radiology (12) and Family Practice (8). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pulaski Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2170744) is associated with this NPI, valid through August 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pulaski Memorial Hospital accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Pulaski Memorial Hospital 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.

When was this NPI record last updated?

The NPPES record for Pulaski Memorial Hospital was last updated on December 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.