Dr Nicholas Defauw, DO in Goshen, IN - Medicare Sports Medicine

Dr Nicholas Defauw, DO is a medicare enrolled "Family Medicine" physician in Goshen, Indiana. He went to Michigan State University College Of Osteopathic Medicine and graduated in 2009 and has 17 years of diverse experience with area of expertise as Sports Medicine. His current practice location is 1111 Lighthouse Ln, Goshen, Indiana. You can reach out to his office (for appointments etc.) via phone at (260) 266-4007.

Dr Nicholas Defauw is licensed to practice in Indiana (license number 02005770A) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1578791398.

Contact Information

	Dr Nicholas Defauw, DO
	1111 Lighthouse Ln, Goshen, IN 46526-3824
	(260) 266-4007
	(260) 266-7355

Map and Direction

Physician's Profile

Full Name	Dr Nicholas Defauw
Gender	Male
Speciality	Sports Medicine
Experience	17 Years
Location	1111 Lighthouse Ln, Goshen, Indiana
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Nicholas Defauw attended and graduated from Michigan State University College Of Osteopathic Medicine in 2009

NPI Data:

NPI Number: 1578791398
Provider Enumeration Date: 07/01/2009
Last Update Date: 05/04/2026

Medicare PECOS Information:

PECOS PAC ID: 8224271978
Enrollment ID: I20190821000929

Medical Identifiers

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

Identifier	Type	State	Issuer
1578791398	NPI	-	NPPES
300029326	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	02005770A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Goshen Hospital	Goshen, IN	Hospital

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. Dr Nicholas Defauw allows following entities to bill medicare on his behalf.

Entity Name	Goshen Health System Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194772293 PECOS PAC ID: 4880598572 Enrollment ID: O20031124000658

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. Dr Nicholas Defauw 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 Address	Practice Location Address
Dr Nicholas Defauw, DO 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () -	Dr Nicholas Defauw, DO 1111 Lighthouse Ln, Goshen, IN 46526-3824 Ph: (260) 266-4007

Reviews and Comments

Family Medicine Doctors in Goshen, IN

Frank Louis Piaskowy, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2120 Rieth Blvd, Ste C, Goshen, IN 46526 Phone: 574-875-4914
Dr. Christina Haimes, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2016 S Main St, Goshen, IN 46526 Phone: 574-533-7600 Fax: 574-533-7666
Dr. Jeffrey A. Eck, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2824 Elkhart Rd, Goshen, IN 46526 Phone: 574-535-1700 Fax: 574-535-1799
Jingpin Li, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2016 S Main St, Goshen, IN 46526 Phone: 574-533-7600 Fax: 574-364-7666
Dr. Laura E Munkel, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2120 Rieth Blvd, Suite A, Goshen, IN 46526 Phone: 574-875-5126 Fax: 574-875-1874
Dr. Brian D. King, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2014 S Main St, Suite B, Goshen, IN 46526 Phone: 574-533-8639 Fax: 574-534-9542
Sam Joseph Borrelli, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2120 Rieth Blvd Ste C, Goshen, IN 46526 Phone: 574-875-6911 Fax: 574-875-1057

Dr Nicholas Defauw, DO - Medicare Sports Medicine in Goshen, IN