| Patrick B Ilada, MD | |
|
1000 Provident Dr Ste C, Warsaw, IN 46580-3255 | |
| (574) 267-8728 | |
| (574) 269-3470 |
| Full Name | Patrick B Ilada |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 29 Years |
| Location | 1000 Provident Dr Ste C, Warsaw, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508803081 | NPI | - | NPPES |
| 200326000 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 01054010A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kosciusko Community Hospital | Warsaw, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kosciusko Medical Group Llc | 5496809956 | 35 |
| Entity Name | Kosciusko Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932349594 PECOS PAC ID: 5496809956 Enrollment ID: O20090818000398 |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick B Ilada, MD 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934 Ph: (260) 479-3513 | Patrick B Ilada, MD 1000 Provident Dr Ste C, Warsaw, IN 46580-3255 Ph: (574) 267-8728 |
Mary Otoo, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2101 Dubois Dr, Warsaw, IN 46580 Phone: 574-267-3200 Fax: 574-372-7649 | |
Dr. Corey French Graham, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Provident Dr, Suite C, Warsaw, IN 46580 Phone: 574-267-8728 Fax: 574-269-3470 | |
Dr. Kishan T Kishan, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2219 Dubois Dr, Warsaw, IN 46580 Phone: 574-269-3420 Fax: 574-269-2234 | |
Dr. Adria Lynn Ford, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Medpark Drive, Suite C, Warsaw, IN 46580 Phone: 574-267-8728 Fax: 574-269-3470 |