PULASKI MEMORIAL HOSPITAL NORTH JUDSON FAMILY MEDICINE
NPI 1831679620
Clinic/Center - Rural Health in North Judson, IN
About Pulaski Memorial Hospital North Judson Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PULASKI MEMORIAL HOSPITAL NORTH JUDSON FAMILY MEDICINE (NPI 1831679620) is a healthcare organization registered as a rural health in North Judson, Indiana and active in the NPI registry since August 2018. The organization holds a CLIA Waiver certificate valid through June 9, 2028 and lists Gregg Malott, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
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)
Pulaski Memorial Hospital North Judson Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 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
63Medicare enrollment records show 63 clinicians reassign Medicare billing to Pulaski Memorial Hospital North Judson Family Medicine, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 15
Nearest to this location (20)
See all 63Valparaiso, IN 46383
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 15D2137056
Pulaski Memorial Hospital D/B/A North Judson Family Medicine · North Judson, 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 Pulaski Memorial Hospital's NPI number?
The NPI number for Pulaski Memorial Hospital is 1831679620. It was assigned to this organization in the NPPES registry on August 21, 2018. The provider is doing business as Pulaski Memorial Hospital North Judson Family Medicine.
Where is Pulaski Memorial Hospital located?
Pulaski Memorial Hospital is located at 414 Lane St, North Judson, IN 46366. The listed phone number is (574) 896-4325.
What is Pulaski Memorial Hospital's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Pulaski Memorial Hospital enrolled in Medicare?
Yes. Pulaski Memorial Hospital is registered in the Medicare PECOS enrollment system.
When is Pulaski Memorial Hospital'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 February 28, 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 Pulaski Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 63 clinicians in 15 Medicare specialties reassign their Medicare billing to Pulaski Memorial Hospital. 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 Nurse Practitioner (22), Diagnostic Radiology (12) and Family Practice (8). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pulaski Memorial Hospital hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D2137056) is associated with this NPI, valid through June 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Pulaski Memorial Hospital accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Pulaski Memorial Hospital 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 Pulaski Memorial Hospital was last updated on October 11, 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.
# Pulaski Memorial Hospital North Judson Family Medicine · NPI 1831679620
Rural Health organization in North Judson, Indiana. Organization record, active in the CMS NPPES registry since August 21, 2018.
## Identity
- **NPI:** 1831679620 (Entity type: Organization)
- **Enumerated:** August 21, 2018
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Pulaski Memorial Hospital
- **Organization subpart:** Yes (part of Pulaski Memorial Hospital)
- **Authorized official:** Gregg Malott, CFO
## Practice location
- **Address:** 414 LANE ST, North Judson, IN 46366-1226
- **Phone:** (574) 896-4325
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Indiana, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 63 clinicians in 15 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (22), Diagnostic Radiology (12), Family Practice (8); 2 practice at this address and 5 within 10 miles; [full list](https://npiprofile.com/npi/1831679620/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 11, 2022
- **Other identifiers:** Medicaid 300014361 (IN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1831679620) · Data from the CMS NPPES public registry.