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MICHAEL ALLEN NEMETH M.D.
NPI 1730184813
Surgery - Surgical Critical Care in Valparaiso, IN

Active since June 16, 2005PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
85 E US HIGHWAY 6 STE 240, VALPARAISO, IN 46383(219) 983-6240(219) 983-6040 Get Directions Write a Review

NPPES record last updated: May 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2025, May 8, 2025, Sep 14, 2020 and 1 more (4 updates tracked since 2018).

About Michael Allen Nemeth M.d. NPPES

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

MICHAEL ALLEN NEMETH M.D. (NPI 1730184813) is an individual surgical critical care provider in Valparaiso, Indiana, licensed in Indiana (01032116A) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Sanford Thief River Falls Medical Center, and maintains a secondary practice location in Valparaiso.

NPPES Registry Identity

NPI1730184813
Entity TypeIndividualMale
Primary Taxonomy2086S0102X
Provider Legal NameMICHAEL ALLEN NEMETHCredential: M.D.
Location Address85 E US HIGHWAY 6 STE 240Valparaiso, IN 46383
Mailing Address2022 Kelle DrChesterton, IN 46304-8708 · (219) 364-3616 · Fax (219) 364-3610
Phone(219) 983-6240
Fax(219) 983-6040
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateJune 16, 2005
Last NPPES UpdateMay 23, 20254 updates tracked since enumeration
NPPES CertifiedMay 23, 2025
✔ NPI 1730184813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians
Taxonomy Code2086S0102X
License✔ Licensed in IN · 01032116A
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedSurgeryTaxonomy 208600000X · License 42010 (MN), 17092 (SD)
85 E US HIGHWAY 6 STE 240, Valparaiso, IN 46383
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Secondary Practice Location 1

Location 12000 Roosevelt Rd Ste 104Valparaiso, IN 46383-2801 · Phone (219) 983-6240 · Fax (219) 983-6040

Other Identifiers 2

Other000000215818IN · Anthem
Medicaid200360900IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Allen Nemeth M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779486147
PECOS Enrollment IDI20250602000207
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
132 services94 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
31 services20 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
26 services26 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
16 services16 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Thief River Falls Medical Center

Critical Access Hospitals · Thief River Falls, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241381
Location3001 Sanford ParkwayThief River Falls, MN 56701 · Pennington County
Emergency services

Androscoggin Valley Hospital

Critical Access Hospitals · Berlin, NH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number301310
Location59 Page Hill RoadBerlin, NH 03570 · Coos County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.04
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
62%143 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
49%223 patients3/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
78%36 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,427 patients5/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
54%177 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
48%498 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 145 patients
82%145 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL OWEN YOUNG MD
Colon & Rectal Surgery
85 E US HIGHWAY 6 STE 240
VALPARAISO, IN 46383
Porter County (219) 983-6240
ROLAND LINCOLN THOMAS M.D.
Surgery (Surgical Critical Care)
85 E US HIGHWAY 6 STE 240
VALPARAISO, IN 46383
Porter County (219) 983-6240
JAC ALAN COOPER SR. M.D.
Surgery (Surgical Critical Care)
85 E US HIGHWAY 6 STE 240
VALPARAISO, IN 46383
Porter County (219) 983-6240

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 Michael Nemeth's NPI number?

The NPI number for Michael Nemeth is 1730184813. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Michael Nemeth located?

Michael Nemeth practices at 85 E Us Highway 6 Ste 240, Valparaiso, IN 46383. The listed phone number is (219) 983-6240.

What is Michael Nemeth's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Is Michael Nemeth enrolled in Medicare?

Yes. Michael Nemeth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Nemeth accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield and 3 other insurers list Michael Nemeth 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.

Is Michael Nemeth affiliated with any hospitals?

According to CMS data, Michael Nemeth is affiliated with Sanford Thief River Falls Medical Center and Androscoggin Valley Hospital.

When was this NPI record last updated?

The NPPES record for Michael Nemeth was last updated on May 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.