SOUTH BEND MEDICAL FOUNDATION, INC
NPI 1649241084
Pathology - Anatomic Pathology & Clinical Pathology in South Bend, IN
About South Bend Medical Foundation, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH BEND MEDICAL FOUNDATION, INC (NPI 1649241084) is a healthcare organization registered as an anatomic pathology & clinical pathology in South Bend, Indiana and active in the NPI registry since February 2006. The organization holds 2 active CLIA laboratory certificates and lists Terry Pipp, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 6
Group Practice 1
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)
South Bend Medical Foundation, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
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.
Clinicians Billing Medicare Through This Organization
19Medicare enrollment records show 19 clinicians reassign Medicare billing to South Bend Medical Foundation, Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians, nearest first (19)
South Bend, IN 46601
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 2
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 Accreditation 15D0357169
South Bend Medical Foundation · South Bend, INCertificate of Compliance 15D0977972
South Bend Medical Foundation/ Fcl-Allied Physician · South Bend, INAreas of Expertise CMS Part B claims 19
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.
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 South Bend Medical Foundation, Inc's NPI number?
The NPI number for South Bend Medical Foundation, Inc is 1649241084. It was assigned to this organization in the NPPES registry on February 1, 2006.
Where is South Bend Medical Foundation, Inc located?
South Bend Medical Foundation, Inc is located at 3355 Douglas Rd, South Bend, IN 46635. The listed phone number is (574) 234-4176.
What is South Bend Medical Foundation, Inc's specialty?
The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.
Is South Bend Medical Foundation, Inc enrolled in Medicare?
Yes. South Bend Medical Foundation, Inc is registered in the Medicare PECOS enrollment system.
When is South Bend Medical Foundation, Inc'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, Independent Clinical Laboratory) is due for revalidation by October 31, 2026. 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 South Bend Medical Foundation, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians, all in Pathology, reassign their Medicare billing to South Bend Medical Foundation, Inc. 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. Of these, 1 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Bend Medical Foundation, Inc hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does South Bend Medical Foundation, Inc accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Priority Health list South Bend Medical Foundation, Inc 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 South Bend Medical Foundation, Inc was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# South Bend Medical Foundation, Inc · NPI 1649241084
Anatomic Pathology & Clinical Pathology organization in South Bend, Indiana. Organization record, active in the CMS NPPES registry since February 1, 2006.
## Identity
- **NPI:** 1649241084 (Entity type: Organization)
- **Enumerated:** February 1, 2006
- **Primary specialty:** Pathology - Anatomic Pathology & Clinical Pathology · taxonomy 207ZP0102X
- **Organization subpart:** No
- **Authorized official:** Terry Pipp, CFO
## Practice location
- **Address:** 3355 DOUGLAS RD, South Bend, IN 46635-1779
- **Phone:** (574) 234-4176
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Indiana, Independent Clinical Laboratory) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 19 clinicians (Pathology) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 16, 2026
- **Other identifiers:** Medicaid 100112700A (IN); Medicaid 169513624 (MI); Other 000000097080; and 3 more
- **CLIA laboratory certificates:** 2 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1649241084) · Data from the CMS NPPES public registry.