Amy Van De Wielle, - Medicare Nurse Practitioner in South Bend, IN

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Amy Van De Wielle, is a medicare enrolled "Nurse Practitioner - Primary Care" physician in South Bend, Indiana. Her current practice location is 211 N Eddy St, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 204-6522.

Amy Van De Wielle is licensed to practice in Michigan (license number 4704393829) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144953902.

Contact Information

Amy Van De Wielle,
211 N Eddy St,
South Bend, IN 46617-3096
(574) 204-6522
Not Available

Map and Direction




Physician's Profile

Full NameAmy Van De Wielle
GenderFemale
SpecialityNurse Practitioner - Primary Care
Location211 N Eddy St, South Bend, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1144953902
  • Provider Enumeration Date: 07/07/2022
  • Last Update Date: 03/08/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9830572841
  • Enrollment ID: I20221208002244

Medical Identifiers

Medical identifiers for Amy Van De Wielle such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144953902NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 1609362375 (Michigan)Secondary
363LP2300XNurse Practitioner - Primary Care 4704393829 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy Van De Wielle allows following entities to bill medicare on her behalf.
Entity NameElkhart Clinic, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164846945
PECOS PAC ID: 2365341674
Enrollment ID: O20040110000052

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Van De Wielle is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Amy Van De Wielle,
211 N Eddy St,
South Bend, IN 46617-3096

Ph: (574) 204-6522		Amy Van De Wielle,
211 N Eddy St,
South Bend, IN 46617-3096

Ph: (574) 204-6522

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.