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GREGORY J PETTAWAY II MD
NPI 1851701841
Emergency Medicine in South Bend, IN

Active since April 30, 2014PECOS EnrolledAccepts Medicare Assignment
615 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-1000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Aug 22, 2017, Jun 22, 2017 (3 updates tracked since 2017).

About Gregory J Pettaway Ii Md NPPES

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

GREGORY J PETTAWAY II MD (NPI 1851701841) is an individual emergency medicine provider in South Bend, Indiana, licensed in Indiana (01078046A) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2014).

NPPES Registry Identity

NPI1851701841
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameGREGORY J PETTAWAY IICredential: MD
Location Address615 N MICHIGAN STSouth Bend, IN 46601-1033
Mailing Address615 N Michigan StSouth Bend, IN 46601-1033 · (574) 647-1817 · Fax (574) 647-3962
Phone(574) 647-1000
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2014
Enumeration DateApril 30, 2014
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1851701841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IN · 01078046A
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
615 N MICHIGAN ST, South Bend, IN 46601
Open in Google Maps ↗

Other Identifiers 2

Medicaid300001115IN
Other941030008IN · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, CareSource.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

Gregory J Pettaway Ii Md 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 ID345562682
PECOS Enrollment IDI20170227000625, I20200123001066
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 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
187 services186 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
119 services108 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
75 services75 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
30 services30 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

AARON MICHAEL MOJICA CRNA
Nurse Anesthetist, Certified Registered
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 612-2476
RACHEL ANN JENNINGS NP
Nurse Practitioner
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1000
DR. GEVORG MARTIROSYAN PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-3119
BRANDON WELLER MD
Ophthalmology
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1000
MELINDA DEUBNER PHARMD
Pharmacist (Critical Care)
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-6302
MELISSA MARIE GLASER RN
Registered Nurse (Case Management)
615 N MICHIGAN ST, MEMORIAL HOSPITAL- COMMUNITY HEALTH ENHANCEMENT
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2173
MRS. NANCY ANN TAGHON RD
Dietitian, Registered
615 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-6351
DR. NICHOLAS HAROLD KERR DO
Family Medicine (Hospice and Palliative Medicine)
615 N MICHIGAN ST, 1ST FL HOSPITALIST STE
SOUTH BEND, IN 46601
St. Joseph County (574) 647-3050

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 Gregory Pettaway's NPI number?

The NPI number for Gregory Pettaway is 1851701841. It was assigned to this individual provider in the NPPES registry on April 30, 2014.

Where is Gregory Pettaway located?

Gregory Pettaway practices at 615 N Michigan St, South Bend, IN 46601. The listed phone number is (574) 647-1000.

What is Gregory Pettaway's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Gregory Pettaway enrolled in Medicare?

Yes. Gregory Pettaway 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 Gregory Pettaway accept?

Health plans from Blue Cross and Blue Shield of Alabama and CareSource list Gregory Pettaway 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 Gregory Pettaway 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.