MICHIANA GASTROENTEROLOGY, INC
NPI 1821094525
Internal Medicine - Gastroenterology in South Bend, IN
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 a CLIA Waiver certificate valid through August 31, 2028 and lists Melissa A Walker, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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)
Michiana Gastroenterology, Inc 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.
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Michiana Gastroenterology, Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (15)
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
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, INFrequently 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.
Is Michiana Gastroenterology, Inc enrolled in Medicare?
Yes. Michiana Gastroenterology, Inc is registered in the Medicare PECOS enrollment system.
When is Michiana Gastroenterology, 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, 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 Michiana Gastroenterology, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 4 Medicare specialties reassign their Medicare billing to Michiana Gastroenterology, 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. The largest specialties are Internal Medicine (6), Nurse Practitioner (4) and Pathology (3). Of these, 3 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Michiana Gastroenterology, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D0357333) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Michiana Gastroenterology, Inc accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield 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.
# Michiana Gastroenterology, Inc · NPI 1821094525
Gastroenterology organization in South Bend, Indiana. Organization record, active in the CMS NPPES registry since June 27, 2005.
## Identity
- **NPI:** 1821094525 (Entity type: Organization)
- **Enumerated:** June 27, 2005
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **Organization subpart:** No
- **Authorized official:** Melissa Walker, ADMINISTRATOR
## Practice location
- **Address:** 17501 GENERATIONS DR, South Bend, IN 46635-1589
- **Phone:** (574) 234-0049 · **Fax:** (574) 251-2861
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Indiana, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 15 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (6), Nurse Practitioner (4), Pathology (3); 3 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Medicaid 100222490A (IN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1821094525) · Data from the CMS NPPES public registry.