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PRIVIA MEDICAL GROUP INDIANA, LLC
NPI 1851497945
Clinic/Center - Multi-Specialty in Mishawaka, IN

Active since September 15, 2006
410 PARK PL STE A, MISHAWAKA, IN 46545(574) 252-0667(574) 807-8845 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2025, May 8, 2019 (2 updates tracked since 2019).

About Privia Medical Group Indiana, Llc NPPES

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

PRIVIA MEDICAL GROUP INDIANA, LLC (NPI 1851497945) is a healthcare organization registered as a multi-specialty in Mishawaka, Indiana and active in the NPI registry since September 2006. The organization lists Kevin R Boyer, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1851497945
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePRIVIA MEDICAL GROUP INDIANA, LLC
Location Address410 PARK PL STE AMishawaka, IN 46545-3557
Mailing Address410 Park Pl, Suite AMishawaka, IN 46545-3557 · (574) 252-0667 · Fax (574) 807-8845
Phone(574) 252-0667
Fax(574) 807-8845
Organization SubpartNo
Authorized OfficialKevin R BoyerChief Executive Officer · (574) 296-3200
Enumeration DateSeptember 15, 2006
Last NPPES UpdateMay 12, 20252 updates tracked since enumeration
NPPES CertifiedMay 12, 2025
✔ NPI 1851497945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
410 PARK PL STE A, Mishawaka, IN 46545
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Other Names 2

Other NameNarcysia Health Care
Other NamePrimary Care At Mishawaka

Other Identifiers 1

Medicaid100466600IN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Privia Medical Group Indiana, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

47

Medicare enrollment records show 47 clinicians reassign Medicare billing to Privia Medical Group Indiana, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 39 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 19

Nurse Practitioner12
Family Practice10
Internal Medicine6
Gastroenterology2
General Surgery2
Podiatry2
Allergy/Immunology1
Anesthesiology1
11 other specialties11

Nearest to this location (20)

See all 47
Scott Rutchik, M.D.
Urology
NPI 1952356503
410 PARK PL STE B
Mishawaka, IN 46545
(574) 855-5800
✔ PECOS✔ Accepts MedicareSame address
Bancy Mwangi, FNP-BC
Nurse Practitioner
NPI 1427828854
53779 GENERATIONS DR STE D
South Bend, IN 46635
(574) 383-8072
✔ PECOS✔ Accepts Medicare1.7 mi
John Bulger, M.D.
Family Practice
NPI 1821123035
303 S MAIN ST SUITE 200
Mishawaka, IN 46544
(574) 255-8285
✔ PECOS✔ Accepts Medicare2.6 mi
Laura Kanyimbo, DNP
Nurse Practitioner
NPI 1811744931
610 N MICHIGAN ST STE 400
South Bend, IN 46601
(574) 647-8120
✔ PECOS✔ Accepts Medicare3.8 mi
Jennifer Hartl, FNP-C
Nurse Practitioner
NPI 1144681941
621 MEMORIAL DR STE 100
South Bend, IN 46601
(574) 647-1100
✔ PECOS✔ Accepts Medicare4.0 mi
John Karagiannis, M.D.
Gastroenterology
NPI 1386647170
621 MEMORIAL DR STE 511
South Bend, IN 46601
(574) 544-5580
✔ PECOS✔ Accepts Medicare4.0 mi
James Jin, M.D.
Medical Oncology
NPI 1215900311
615 N MICHIGAN ST
South Bend, IN 46601
(574) 647-1100
✔ PECOS✔ Accepts Medicare4.2 mi
Jennifer Besemer, RD, CDE
Registered Dietitian or Nutrition Professional
NPI 1578013058
1815 E IRELAND RD
South Bend, IN 46614
(574) 647-1700
✔ Accepts Medicare5.1 mi
Ruth Neal, APRN
Nurse Practitioner
NPI 1396414827
1815 E IRELAND RD
South Bend, IN 46614
(574) 647-1700
✔ PECOS✔ Accepts Medicare5.1 mi
Jeffrey Eifler, D.P.M.
Podiatry
NPI 1003178690
2235 CLEVELAND RD
South Bend, IN 46628
(574) 647-4530
✔ PECOS✔ Accepts Medicare5.7 mi
Katarina Moskalow, M.D.
Family Practice
NPI 1508508706
2115 W LEXINGTON AVE
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare9.0 mi
Melissa Henderson, O.D
Optometry
NPI 1376982074
2222 W LEXINGTON AVE
Elkhart, IN 46514
(574) 294-3030
✔ PECOS✔ Accepts Medicare9.0 mi
Eric Johnson, M.D.
Otolaryngology
NPI 1245201169
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3291
✔ PECOS✔ Accepts Medicare9.1 mi
Luisito Gonzales, M.D.
Cardiovascular Disease (Cardiology)
NPI 1164425997
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3466
✔ PECOS✔ Accepts Medicare9.1 mi
Nazmul Huda, MD
Interventional Cardiology
NPI 1609076777
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3338
✔ PECOS✔ Accepts Medicare9.1 mi
Pavan Ahuja, M.D.
Internal Medicine
NPI 1578566675
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3307
✔ PECOS✔ Accepts Medicare9.1 mi
Matthew Deere
General Surgery
NPI 1952797771
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare9.1 mi
Kenneth Gammon, M.D.
Pulmonary Disease
NPI 1528061447
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3314
✔ PECOS✔ Accepts Medicare9.1 mi
Gordon Hughes, MD
Rheumatology
NPI 1003895681
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare9.1 mi
Mamoon Raza, M.D.
Gastroenterology
NPI 1326098013
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3341
✔ PECOS✔ Accepts Medicare9.1 mi
See all 47 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Privia Medical Group Indiana, LLC's NPI number?

The NPI number for Privia Medical Group Indiana, LLC is 1851497945. It was assigned to this organization in the NPPES registry on September 15, 2006. The provider is also known as Narcysia Health Care and Primary Care at Mishawaka.

Where is Privia Medical Group Indiana, LLC located?

Privia Medical Group Indiana, LLC is located at 410 Park Pl Ste A, Mishawaka, IN 46545. The listed phone number is (574) 252-0667.

What is Privia Medical Group Indiana, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Privia Medical Group Indiana, LLC enrolled in Medicare?

Yes. Privia Medical Group Indiana, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Privia Medical Group Indiana, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 47 clinicians in 19 Medicare specialties reassign their Medicare billing to Privia Medical Group Indiana, LLC. 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 (12), Family Practice (10) and Internal Medicine (6). Of these, 1 practice at this address and 39 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Privia Medical Group Indiana, LLC was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.