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GREAT LAKES ORTHOPEDICS & SPORTS MEDICINE, PC
NPI 1669472270
Orthopaedic Surgery in Saint John, IN

Active since July 26, 2005
9615 KEILMAN ST, SAINT JOHN, IN 46373(219) 365-0220(219) 365-0226 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 17, 2018, Jan 9, 2018 (2 updates tracked since 2018).

About Great Lakes Orthopedics & Sports Medicine, Pc NPPES

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

GREAT LAKES ORTHOPEDICS & SPORTS MEDICINE, PC (NPI 1669472270) is a healthcare organization registered as an orthopaedic surgery in Saint John, Indiana and active in the NPI registry since July 2005. The organization maintains a secondary practice location in Lowell and lists Keith R. Pitchford, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1669472270
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameGREAT LAKES ORTHOPEDICS & SPORTS MEDICINE, PC
Location Address9615 KEILMAN STSaint John, IN 46373-9406
Mailing Address9615 Keilman StSaint John, IN 46373-9406 · (219) 365-0220 · Fax (219) 365-0226
Phone(219) 365-0220
Fax(219) 365-0226
Organization SubpartNo
Authorized OfficialKeith R. PitchfordPresident/ceo · (219) 365-0220
Enumeration DateJuly 26, 2005
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1669472270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in IN · 02002102
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X · License 07001187A (IN)
9615 KEILMAN ST, Saint John, IN 46373
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Secondary Practice Location 1

Location 11020 E Commercial AveLowell, IN 46356-2310 · Phone (219) 696-6353 · Fax (219) 696-6368

Other Identifiers 2

Other90001186IL · Bc/bs Il
OtherDC2442IN · Railroad Medicare

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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)

Great Lakes Orthopedics & Sports Medicine, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 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 IDO20040209001009Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Great Lakes Orthopedics & Sports Medicine, PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Keith Pitchford, D.O.
Orthopedic Surgery
NPI 1568462729
9615 KEILMAN STREET
Saint John, IN 46373
(219) 365-0220
✔ PECOS✔ Accepts MedicareSame address
Natasha Mandula, DPM
Podiatry
NPI 1851682561
756 N MAIN ST STE N
Crown Point, IN 46307
(219) 257-0255
✔ PECOS✔ Accepts Medicare5.7 mi
Kristen Giacomin, N.P.
Nurse Practitioner
NPI 1952950560
118 E 90TH DR
Merrillville, IN 46410
(219) 736-2922
✔ PECOS✔ Accepts Medicare7.2 mi
Curt Martini, DPM
Podiatry
NPI 1427583756
1255 LIBERTY ST
Redding, CA 96001
(530) 246-2467
✔ PECOS✔ Accepts Medicare1,813 mi

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 Great Lakes Orthopedics & Sports Medicine, PC's NPI number?

The NPI number for Great Lakes Orthopedics & Sports Medicine, PC is 1669472270. It was assigned to this organization in the NPPES registry on July 26, 2005.

Where is Great Lakes Orthopedics & Sports Medicine, PC located?

Great Lakes Orthopedics & Sports Medicine, PC is located at 9615 Keilman St, Saint John, IN 46373. The listed phone number is (219) 365-0220.

What is Great Lakes Orthopedics & Sports Medicine, PC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Great Lakes Orthopedics & Sports Medicine, PC enrolled in Medicare?

Yes. Great Lakes Orthopedics & Sports Medicine, PC is registered in the Medicare PECOS enrollment system.

When is Great Lakes Orthopedics & Sports Medicine, PC'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 March 31, 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 Great Lakes Orthopedics & Sports Medicine, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Great Lakes Orthopedics & Sports Medicine, PC, in Nurse Practitioner, Orthopedic Surgery and Podiatry. 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 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Great Lakes Orthopedics & Sports Medicine, PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Great Lakes Orthopedics & Sports Medicine, PC 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 Great Lakes Orthopedics & Sports Medicine, PC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.