<unavail> in Mishawaka, IN - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Mishawaka, Indiana. The current practice location for is 420 W 4th St, Mishawaka, Indiana. For appointments, you can reach them via phone at (574) 307-7673. The mailing address for is 2401 Valley Dr, Valparaiso, Indiana and phone number is (219) 413-5100.

is licensed to practice in Indiana (license number H80CS06662). The clinic also participates in the medicare program and its NPI number is 1417244989. 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) 307-7673.

Contact Information


	420 W 4th St Mishawaka IN 46544
	(574) 307-7673
	(574) 307-7692

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	420 W 4th St, Mishawaka, Indiana
Authorized Official Name and Position	Melissa Mitchell (CEO)
Authorized Official Contact	2194659503
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
2401 Valley Dr Valparaiso IN 46383-2520 Ph: (219) 413-5100	420 W 4th St Mishawaka IN 46544 Ph: (574) 307-7673

NPI Details:

NPI Number	1417244989
Provider Enumeration Date	07/06/2011
Last Update Date	01/12/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	7618929373
Medicare Enrollment ID	O20110809000646

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417244989	NPI	-	NPPES
200317310E	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	H80CS06662 (Indiana)	Primary

Reviews and Comments

Clinic/Center in Mishawaka, IN

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- Medicare Primary Care in Mishawaka, IN