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DR. AMANDA KATHRINE WILLEMS DUTKIEWICZ M.D.
NPI 1891989539
Pediatrics in South Bend, IN

Active since September 05, 2007PECOS Enrolled
615 N MICHIGAN ST, 5TH FL, SOUTH BEND, IN 46601(574) 647-7275(574) 647-3696 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 1, 2021, Jun 7, 2017 (2 updates tracked since 2017).

About Dr. Amanda Kathrine Willems Dutkiewicz M.d. NPPES

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

DR. AMANDA KATHRINE WILLEMS DUTKIEWICZ M.D. (NPI 1891989539) is an individual pediatrics provider in South Bend, Indiana, licensed in Indiana (01063419A) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891989539
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. AMANDA KATHRINE WILLEMS DUTKIEWICZCredential: M.D.
Location Address615 N MICHIGAN ST, 5TH FLSouth Bend, IN 46601-1033
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Phone(574) 647-7275
Fax(574) 647-3696
Sole ProprietorNo
Enumeration DateSeptember 5, 2007
Last NPPES UpdateApril 28, 20232 updates tracked since enumeration
NPPES CertifiedApril 28, 2023
✔ NPI 1891989539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IN · 01063419A
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
615 N MICHIGAN ST, South Bend, IN 46601
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Other Names 1

Former Name (1)Amanda Kathrine Willems

Other Identifiers 1

Medicaid200886800IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Amanda Kathrine Willems Dutkiewicz M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Amanda Dutkiewicz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beacon Medical Group, Inc.
Same address
Pediatric Critical Care Medicine
615 N MICHIGAN ST 5TH FL
South Bend, IN 46601
  • Reassigned Medicare billing, Indiana enrollment
  • 734 clinicians in this Medicare group
NPI 1467408237 (574) 647-7275

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

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 Amanda Dutkiewicz's NPI number?

The NPI number for Amanda Dutkiewicz is 1891989539. It was assigned to this individual provider in the NPPES registry on September 5, 2007. The provider is also known as Amanda Kathrine Willems.

Where is Amanda Dutkiewicz located?

Amanda Dutkiewicz practices at 615 N Michigan St 5th Fl, South Bend, IN 46601. The listed phone number is (574) 647-7275.

What is Amanda Dutkiewicz's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Amanda Dutkiewicz enrolled in Medicare?

Yes. Amanda Dutkiewicz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amanda Dutkiewicz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Dutkiewicz reassigns Medicare benefits to Beacon Medical Group, Inc. (South Bend, IN). The 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 Amanda Dutkiewicz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Dutkiewicz accept?

Health plans from CareSource list Amanda Dutkiewicz 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 Amanda Dutkiewicz was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.