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MICHIANA GASTROENTEROLOGY, INC
NPI 1821094525
Internal Medicine - Gastroenterology in South Bend, IN

Active since June 27, 2005CLIA Certified · 2 labs
17501 GENERATIONS DR, SOUTH BEND, IN 46635(574) 234-0049(574) 251-2861 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michiana Gastroenterology, Inc NPPES

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

MICHIANA GASTROENTEROLOGY, INC (NPI 1821094525) is a healthcare organization registered as a gastroenterology in South Bend, Indiana and active in the NPI registry since June 2005. The organization holds 2 active CLIA laboratory certificates and lists Melissa A Walker, Administrator, as its authorized official.

NPPES Registry Identity

NPI1821094525
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameMICHIANA GASTROENTEROLOGY, INC
Location Address17501 GENERATIONS DRSouth Bend, IN 46635-1589
Mailing Address17501 Generations DrSouth Bend, IN 46635-1589 · (574) 234-0049 · Fax (574) 251-2861
Phone(574) 234-0049
Fax(574) 251-2861
Organization SubpartNo
Authorized OfficialMelissa A WalkerAdministrator · (574) 234-0049
Enumeration DateJune 27, 2005
Last NPPES UpdateJuly 21, 2022
✔ NPI 1821094525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
17501 GENERATIONS DR, South Bend, IN 46635
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Other Identifiers 1

Medicaid100222490AIN

Group Practice 1

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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 Waiver 15D0357333

Michiana Gastroenterology Inc · South Bend, IN
Active · expires Aug 31, 2026
CLIA Number15D0357333
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJohn G. Mathis
Laboratory Phone(574) 234-0049
Laboratory LocationMichiana Gastroenterology Inc17501 Generations Dr, South Bend, IN 46635
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 15D2044025

Michiana Gastroenterology Laboratory · South Bend, IN
Active · expires Oct 29, 2026
CLIA Number15D2044025
Laboratory TypePhysician Office
Certificate Effective DateOctober 30, 2024
Certificate Expiration DateOctober 29, 2026
Laboratory DirectorAshley Obannon
Laboratory Phone(574) 245-7979
Laboratory LocationMichiana Gastroenterology Laboratory53830 Generations Drive, Ste 105, South Bend, IN 46635
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 11

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

DR. PANKAJ A PATEL M.D.
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
BRIANA R WEIDLER-EDHOLM NP
Nurse Practitioner
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
DR. JOHN GLENN MATHIS M.D.
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
DR. OLIVER D GILLIAM M.D.
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
DR. THOMAS R VANDERHEYDEN JR. D.O.
Internal Medicine
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
DR. MICHAEL ALAN MANBECK M.D.
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
RAVI J PATEL M.D.
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 234-0049
DR. DAVID G MARK MD
Internal Medicine (Gastroenterology)
17501 GENERATIONS DR
SOUTH BEND, IN 46635
St. Joseph County (574) 000-0000

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 Michiana Gastroenterology, Inc's NPI number?

The NPI number for Michiana Gastroenterology, Inc is 1821094525. It was assigned to this organization in the NPPES registry on June 27, 2005.

Where is Michiana Gastroenterology, Inc located?

Michiana Gastroenterology, Inc is located at 17501 Generations Dr, South Bend, IN 46635. The listed phone number is (574) 234-0049.

What is Michiana Gastroenterology, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Michiana Gastroenterology, 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 Michiana Gastroenterology, Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Michiana Gastroenterology, 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 Michiana Gastroenterology, Inc was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.