Elkhart Clinic, Llc - Medicare Primary Care in Goshen, IN

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Elkhart Clinic, Llc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Goshen, Indiana. The current practice location for Elkhart Clinic, Llc is 1122 Professional Dr, Goshen, Indiana. For appointments, you can reach them via phone at (574) 296-3291. The mailing address for Elkhart Clinic, Llc is Po Box 2968, Elkhart, Indiana and phone number is (574) 296-3200.

Elkhart Clinic, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1164846945. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (574) 296-3291.

Contact Information

Elkhart Clinic, Llc
1122 Professional Dr
Goshen
IN 46526-3819
(574) 296-3291
(574) 296-3383

Map and Direction


Primary Care Clinic Profile

Full NameElkhart Clinic, Llc
SpecialityClinic/Center
Location1122 Professional Dr, Goshen, Indiana
Authorized Official Name and PositionDarryl R. Busby (EXECUTIVE ADMINISTRATOR)
Authorized Official Contact5742963200
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Elkhart Clinic, Llc
Po Box 2968
Elkhart
IN 46515-2968

Ph: (574) 296-3200		Elkhart Clinic, Llc
1122 Professional Dr
Goshen
IN 46526-3819

Ph: (574) 296-3291

NPI Details:

NPI Number1164846945
Provider Enumeration Date02/13/2014
Last Update Date02/13/2014

Medicare PECOS Information:

Medicare PECOS PAC ID2365341674
Medicare Enrollment IDO20040110000052

Medical Identifiers

Medical identifiers for Elkhart Clinic, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164846945NPI-NPPES
100466600MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Elkhart Clinic, Llc acts as a billing entity for following providers:
Provider NameLuisito C Gonzales
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1164425997
PECOS PAC ID: 1759379613
Enrollment ID: I20040501000119
Provider NameEric M Johnson
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1245201169
PECOS PAC ID: 1759363237
Enrollment ID: I20040607001305
Provider NameScott D Rutchik
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1952356503
PECOS PAC ID: 7214928449
Enrollment ID: I20040708001006
Provider NameTimothy Edward Davis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356344204
PECOS PAC ID: 1850379587
Enrollment ID: I20040709000761
Provider NameWai H Lee
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1265435861
PECOS PAC ID: 9638060205
Enrollment ID: I20040713001440
Provider NameAhsanul Haque
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1558364372
PECOS PAC ID: 2466427828
Enrollment ID: I20040830000335
Provider NameAmer Mahmud Kazi
Provider TypePractitioner - Pain Management
Provider IdentifiersNPI Number: 1134122914
PECOS PAC ID: 5991772998
Enrollment ID: I20040910000184
Provider NameVikram Mehta
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1841293461
PECOS PAC ID: 1355300369
Enrollment ID: I20041006000345
Provider NameKamran Fasih Siddiqui
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871596700
PECOS PAC ID: 7810883238
Enrollment ID: I20041108000778
Provider NamePavan Ahuja
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1578566675
PECOS PAC ID: 8426014317
Enrollment ID: I20041202000428
Provider NameHarmanpreet B Rakhra
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1417919481
PECOS PAC ID: 6305894957
Enrollment ID: I20050110001118
Provider NameDeborah Gunden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376514380
PECOS PAC ID: 4486601028
Enrollment ID: I20050405001231
Provider NameJohn W Bulger
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821123035
PECOS PAC ID: 9032150446
Enrollment ID: I20050517000851
Provider NameMyra J Oswald
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942205232
PECOS PAC ID: 3678509338
Enrollment ID: I20050713001029
Provider NameJames Ou Jin
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1215900311
PECOS PAC ID: 9133133051
Enrollment ID: I20060131000341
Provider NameMamoon A Raza
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1326098013
PECOS PAC ID: 6305858861
Enrollment ID: I20060627000123
Provider NameEwa A Bialikiewicz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1114972312
PECOS PAC ID: 2264436765
Enrollment ID: I20060913000527
Provider NameSmita V Patel
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518180512
PECOS PAC ID: 9638260649
Enrollment ID: I20070806000528
Provider NameAaron Young
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750504734
PECOS PAC ID: 0143393686
Enrollment ID: I20080717000059
Provider NameSudeepta A Rakhra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861599300
PECOS PAC ID: 5395637755
Enrollment ID: I20081204000408
Provider NameMinnie S Enriquez
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225031164
PECOS PAC ID: 7911909288
Enrollment ID: I20091001000339
Provider NameWilliam P Buckley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922001098
PECOS PAC ID: 5193727469
Enrollment ID: I20091001000366
Provider NameJena E Gould
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952534943
PECOS PAC ID: 7315082781
Enrollment ID: I20100310000223
Provider NameTimothy J Porsche
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1730184029
PECOS PAC ID: 3971402298
Enrollment ID: I20100315000171
Provider NameGordon M Hughes
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1003895681
PECOS PAC ID: 8628975513
Enrollment ID: I20100614000356
Provider NameBruce Lockwitz
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1043213689
PECOS PAC ID: 2163424433
Enrollment ID: I20100824001253
Provider NameJohn P Karagiannis
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1386647170
PECOS PAC ID: 8426957747
Enrollment ID: I20100830000506
Provider NameHeather A Macklem
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588667117
PECOS PAC ID: 7517969884
Enrollment ID: I20100901000944
Provider NameThomas R Vidic
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1265437404
PECOS PAC ID: 3779585054
Enrollment ID: I20100924000770
Provider NameSuying Wu
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1669477816
PECOS PAC ID: 5597767871
Enrollment ID: I20101004000504
Provider NameSalvatore Joseph Borrelli
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1114028743
PECOS PAC ID: 9335210723
Enrollment ID: I20101101001010
Provider NameHarley W Yoder
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821199431
PECOS PAC ID: 3870664261
Enrollment ID: I20101108000833
Provider NameCarolyn F Hudson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1669475471
PECOS PAC ID: 2466454731
Enrollment ID: I20101109001440
Provider NameCharlotte A Weaver
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1235134487
PECOS PAC ID: 2163619701
Enrollment ID: I20101209000029
Provider NameGeoffrey A Rogers
Provider TypePractitioner - Allergy/immunology
Provider IdentifiersNPI Number: 1265437255
PECOS PAC ID: 9234131517
Enrollment ID: I20101221000703
Provider NameRyan D Matherly
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356344972
PECOS PAC ID: 9335141605
Enrollment ID: I20110103000309
Provider NameKenneth L Gammon
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1528061447
PECOS PAC ID: 8820090194
Enrollment ID: I20110406000220
Provider NameOrlando A Landrum
Provider TypePractitioner - Interventional Pain Management
Provider IdentifiersNPI Number: 1932159910
PECOS PAC ID: 0042229387
Enrollment ID: I20110606000129
Provider NameTiffany N. Szymarek
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1336362318
PECOS PAC ID: 1951596774
Enrollment ID: I20120724000800
Provider NameAbigail Anne Wolaver Johnson
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1194078634
PECOS PAC ID: 6204088982
Enrollment ID: I20121203000336
Provider NameJuanito U Uy
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1851531149
PECOS PAC ID: 4486807955
Enrollment ID: I20130111000282
Provider NameMelissa A Henderson
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1376982074
PECOS PAC ID: 5597991901
Enrollment ID: I20131113000827
Provider NameNazmul Huda
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1609076777
PECOS PAC ID: 4981786175
Enrollment ID: I20140116000716
Provider NameLudmila Y Pichugena-emerson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447669304
PECOS PAC ID: 0749407666
Enrollment ID: I20140815001709
Provider NameJeffrey Eifler
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1003178690
PECOS PAC ID: 1759609639
Enrollment ID: I20150506002236
Provider NameEmily A Mitchell
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1043537020
PECOS PAC ID: 0941519185
Enrollment ID: I20151029000235
Provider NameJennifer A Hartl
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144681941
PECOS PAC ID: 2860781598
Enrollment ID: I20160518002215
Provider NameCipriana Ortega
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083063499
PECOS PAC ID: 9133411630
Enrollment ID: I20160701000289
Provider NameJennifer N Besemer
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1578013058
PECOS PAC ID: 2163701954
Enrollment ID: I20161118001077
Provider NameNicole R Graves
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386135374
PECOS PAC ID: 5193073187
Enrollment ID: I20180808000603
Provider NameKimberlee Lynn Acton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225510522
PECOS PAC ID: 9436409497
Enrollment ID: I20180912002520
Provider NameMarla M Troyer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114482676
PECOS PAC ID: 8921348285
Enrollment ID: I20190322001523
Provider NameMatthew Deere
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1952797771
PECOS PAC ID: 5799107314
Enrollment ID: I20200626000809
Provider NameMatthew Lee Abrell
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1164917167
PECOS PAC ID: 3870849086
Enrollment ID: I20210719000687
Provider NameAmy B Van De Wielle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144953902
PECOS PAC ID: 9830572841
Enrollment ID: I20221208002244
Provider NameVishwanath Pattan
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1770902330
PECOS PAC ID: 9335460666
Enrollment ID: I20230324002511
Provider NameBancy Mwangi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427828854
PECOS PAC ID: 1850737990
Enrollment ID: I20240311003474
Provider NameRuth Neal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396414827
PECOS PAC ID: 8224426275
Enrollment ID: I20240321001442

Reviews and Comments


Clinic/Center in Goshen, IN

Maple City Health Care Center, Inc.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 213 Middlebury St, Goshen, IN 46528
Phone: 574-534-3300    Fax: 574-534-5412
Goshen Family Physicians
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1811 Charlton Ct, Goshen, IN 46526
Phone: 574-534-8200    Fax: 574-534-0411
Krabill Family Medicine
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1806 Charlton Ct, Goshen, IN 46526
Phone: 574-534-2400    
Goshen Health System Inc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 2004 Elkhart Rd Ste A, Goshen, IN 46526
Phone: 574-364-2611    Fax: 574-364-2784
Goshen Health System, Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1814 Charlton Ct Ste A, Goshen, IN 46526
Phone: 574-533-4169    Fax: 574-534-8822
Goshen Health System Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1615 Winsted Dr Ste 2, Goshen, IN 46526
Phone: 574-537-1625    Fax: 574-537-9384

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.