Mrs Susana Diaz, CNM in South Bend, IN - Medicare Advanced Practice Midwife

Mrs Susana Diaz, CNM is a medicare enrolled "Advanced Practice Midwife" in South Bend, Indiana. Her current practice location is 621 Memorial Dr Ste 403, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 647-1405.

Mrs Susana Diaz is licensed to practice in Indiana (license number 09000225A) 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 1972857704.

Contact Information

	Mrs Susana Diaz, CNM
	621 Memorial Dr Ste 403, South Bend, IN 46601-1074
	(574) 647-1405
	(574) 647-3970

Map and Direction

Provider's Profile

Full Name	Mrs Susana Diaz
Gender	Female
Speciality	Advanced Practice Midwife
Location	621 Memorial Dr Ste 403, South Bend, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1972857704
Provider Enumeration Date: 10/31/2012
Last Update Date: 04/01/2021

Medicare PECOS Information:

PECOS PAC ID: 7315183993
Enrollment ID: I20130426000559

Medical Identifiers

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

Identifier	Type	State	Issuer
1972857704	NPI	-	NPPES
178420006	Other	IN	MEDICARE PTAN
201132350	Medicaid	IN
236040262	Other	IN	MEDICARE PTAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	09000225A (Indiana)	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. Mrs Susana Diaz allows following entities to bill medicare on her behalf.

Entity Name	Beacon Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657

Entity Name	Healthlinc Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528262581 PECOS PAC ID: 7618929373 Enrollment ID: O20050210000929

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. Mrs Susana Diaz 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
Mrs Susana Diaz, CNM 710 N. Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610	Mrs Susana Diaz, CNM 621 Memorial Dr Ste 403, South Bend, IN 46601-1074 Ph: (574) 647-1405

Reviews and Comments

Advanced Practice Midwife Nurses in South Bend, IN

Amber Taylor, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr Ste 403, South Bend, IN 46601 Phone: 574-647-1405 Fax: 574-647-3970
Hannah Grace Yoder, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 621 Memorial Dr Ste 403, South Bend, IN 46601 Phone: 547-647-1405
Mrs. Shannon Lee Luczak, APN Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 515 N Lafayette Blvd, South Bend, IN 46601 Phone: 574-232-2037
Laura Theresa Mabry, MSN, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr Ste 403, South Bend, IN 46601 Phone: 574-647-1405 Fax: 574-647-3970
Emilie Harvey, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr Ste 403, South Bend, IN 46601 Phone: 574-647-1405 Fax: 574-647-3970
Ms. Kristin Joy Kile, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr, Ste 403, South Bend, IN 46601 Phone: 574-647-1405
Melissa E Holderread, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr, Ste 403, South Bend, IN 46601 Phone: 574-647-1405 Fax: 574-647-3970

Mrs Susana Diaz, CNM - Medicare Advanced Practice Midwife in South Bend, IN