EVANS KIRKWOOD LODGE MD, PHD
NPI 1710737366
Family Medicine in South Bend, IN

NPI Status: Active since March 26, 2024

Contact Information

714 N MICHIGAN ST
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-7477

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Family Medicine
PECOS Enrolled

About EVANS LODGE

This page provides the complete NPI Profile along with additional information for Evans Lodge, a primary care provider established in South Bend, Indiana with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1710737366 assigned on March 2024. The practitioner's primary taxonomy code is 207Q00000X with license number 01097297A (IN). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1710737366
Provider Name: EVANS KIRKWOOD LODGE MD, PHD
Gender: Male
Entity Type: Individual
Location Address: 714 N MICHIGAN ST SOUTH BEND, IN 46601
Location Phone: (574) 647-7477
Mailing Address: 714 N MICHIGAN ST SOUTH BEND, IN 46601
Mailing Phone: (574) 647-7477
Mailing Fax
Is Sole Proprietor?: No
Enumeration Date: 03-26-2024
Last Update Date: 12-08-2025
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A primary care provider (PCP) like Evans Lodge sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
License No.: 01097297A
License State: IN
Taxonomy Description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Medicare Participation & PECOS Enrollment Status

Evans Lodge is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 46601 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.04
Minimum New Patient Price $53.07
Maximum New Patient Price $161.76

Average New Patient Copayment $20.51
Minimum New Patient Copayment $13.26
Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $94.22
Minimum Established Patient Price $16.93
Maximum Established Patient Price $132.22

Average Established Patient Copayment $23.55
Minimum Established Patient Copayment $4.23
Maximum Established Patient Copayment $33.05

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1710737366, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 7 → 14 → 5 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 2 + 0 + 1 + 4 + 3 + 1 + 4 + 3 + 1 + 2 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1710737366.