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PRIVIA MEDICAL GROUP INDIANA, LLC
NPI 1568147809
Nurse Practitioner - Family in Wakarusa, IN

Active since June 15, 2023
100 N. ELKHART ST, WAKARUSA, IN 46573(574) 296-3200 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 12, 2025, Jun 15, 2023 (2 updates tracked since 2023).

About Privia Medical Group Indiana, Llc NPPES

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

PRIVIA MEDICAL GROUP INDIANA, LLC (NPI 1568147809) is a healthcare organization registered as a family in Wakarusa, Indiana and active in the NPI registry since June 2023. The organization lists Megan Leigh Carlson, Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1568147809
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePRIVIA MEDICAL GROUP INDIANA, LLC
Location Address100 N. ELKHART STWakarusa, IN 46573
Mailing AddressPo Box 778985Chicago, IL 60677-8985 · (574) 296-3390 · Fax (574) 296-3392
Phone(574) 296-3200
Organization SubpartYesParent: Elkhart Clinic, Llc
Authorized OfficialMegan Leigh CarlsonProvider Enrollment · (574) 296-3991
Enumeration DateJune 15, 2023
Last NPPES UpdateMay 12, 20252 updates tracked since enumeration
NPPES CertifiedMay 12, 2025
✔ NPI 1568147809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
100 N. ELKHART ST, Wakarusa, IN 46573
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Other Names 1

Other NameElkhart Clinic Wakarusa

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

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Privia Medical Group Indiana, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

47

Medicare enrollment records show 47 clinicians reassign Medicare billing to Privia Medical Group Indiana, LLC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 19

Nurse Practitioner12
Family Practice10
Internal Medicine6
Gastroenterology2
General Surgery2
Podiatry2
Allergy/Immunology1
Anesthesiology1
11 other specialties11

Nearest to this location (20)

See all 47
Harley Yoder, M.D.
Family Practice
NPI 1821199431
25651 COUNTY ROAD 20
Elkhart, IN 46517
(574) 522-1201
✔ PECOS✔ Accepts Medicare8.4 mi
Hoda Rahmani, MD
Family Practice
NPI 1063975332
25651 COUNTY ROAD 20
Elkhart, IN 46517
(571) 244-2261
✔ PECOS✔ Accepts Medicare8.5 mi
Cipriana Ortega
Nurse Practitioner
NPI 1083063499
400 W LINCOLN AVE
Goshen, IN 46526
(574) 533-7600
✔ PECOS✔ Accepts Medicare10.0 mi
Matthew Abrell, DPM
Podiatry
NPI 1164917167
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare10 mi
Pavan Ahuja, M.D.
Internal Medicine
NPI 1578566675
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3307
✔ PECOS✔ Accepts Medicare10 mi
Matthew Deere
General Surgery
NPI 1952797771
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare10 mi
Kenneth Gammon, M.D.
Pulmonary Disease
NPI 1528061447
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3314
✔ PECOS✔ Accepts Medicare10 mi
Gordon Hughes, MD
Rheumatology
NPI 1003895681
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare10 mi
Vikram Mehta, M.D.
Family Practice
NPI 1841293461
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3296
✔ PECOS✔ Accepts Medicare10 mi
Mamoon Raza, M.D.
Gastroenterology
NPI 1326098013
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3341
✔ PECOS✔ Accepts Medicare10 mi
Geoffrey Rogers, M.D.
Allergy/Immunology
NPI 1265437255
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3314
✔ PECOS✔ Accepts Medicare10 mi
Thomas Vidic, M.D.
Neurology
NPI 1265437404
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3282
✔ PECOS✔ Accepts Medicare10 mi
Dayna Gerring, FNP-BC
Nurse Practitioner
NPI 1184010936
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare10 mi
Eric Johnson, M.D.
Otolaryngology
NPI 1245201169
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3291
✔ PECOS✔ Accepts Medicare10 mi
Melissa Henderson, O.D
Optometry
NPI 1376982074
2222 W LEXINGTON AVE
Elkhart, IN 46514
(574) 294-3030
✔ PECOS✔ Accepts Medicare10 mi
Luisito Gonzales, M.D.
Cardiovascular Disease (Cardiology)
NPI 1164425997
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3466
✔ PECOS✔ Accepts Medicare10 mi
Nazmul Huda, MD
Interventional Cardiology
NPI 1609076777
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3338
✔ PECOS✔ Accepts Medicare10 mi
Orlando Landrum, MD
Anesthesiology
NPI 1932159910
242 WATERFALL DR SUITE B
Elkhart, IN 46516
(574) 404-7246
✔ PECOS11 mi
Tiffany Szymarek, MD
Ophthalmology
NPI 1336362318
1628 W BEARDSLEY AVE
Elkhart, IN 46514
(574) 391-1020
✔ PECOS✔ Accepts Medicare11 mi
Jennifer Besemer, RD, CDE
Registered Dietitian or Nutrition Professional
NPI 1578013058
1815 E IRELAND RD
South Bend, IN 46614
(574) 647-1700
✔ Accepts Medicare12 mi
See all 47 clinicians

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

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 Privia Medical Group Indiana, LLC's NPI number?

The NPI number for Privia Medical Group Indiana, LLC is 1568147809. It was assigned to this organization in the NPPES registry on June 15, 2023. The provider is also known as Elkhart Clinic Wakarusa.

Where is Privia Medical Group Indiana, LLC located?

Privia Medical Group Indiana, LLC is located at 100 N. Elkhart St, Wakarusa, IN 46573. The listed phone number is (574) 296-3200.

What is Privia Medical Group Indiana, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Privia Medical Group Indiana, LLC enrolled in Medicare?

Yes. Privia Medical Group Indiana, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Privia Medical Group Indiana, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 47 clinicians in 19 Medicare specialties reassign their Medicare billing to Privia Medical Group Indiana, LLC. 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 (12), Family Practice (10) and Internal Medicine (6). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Privia Medical Group Indiana, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Privia Medical Group Indiana, LLC 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 Privia Medical Group Indiana, LLC was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.