| Privia Medical Group Indiana, Llc | |
|
410 Park Pl Suite B Mishawaka IN 46545-3557 | |
| (574) 855-5800 | |
| (574) 855-5805 |
| Full Name | Privia Medical Group Indiana, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 410 Park Pl, Mishawaka, Indiana |
| Authorized Official Name and Position | Timothy Porsche (MANAGING PARTNER) |
| Authorized Official Contact | 5742963200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Privia Medical Group Indiana, Llc Po Box 2968 Elkhart IN 46515-2968 Ph: (574) 296-3200 | Privia Medical Group Indiana, Llc 410 Park Pl Suite B Mishawaka IN 46545-3557 Ph: (574) 855-5800 |
| NPI Number | 1235303165 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 05/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235303165 | NPI | - | NPPES |
| 100466600D | Medicaid | IN | |
| 0359310002 | Other | IN | MEDICARE NSC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Saint Joseph Pace Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 E Day Rd, Mishawaka, IN 46545 Phone: 574-247-8700 | |
Allied Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 W Catalpa Dr, Suite A, Mishawaka, IN 46545 Phone: 574-255-1522 Fax: 574-255-1540 | |
Honor Physicians, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3809 N Main St Ste 100, Mishawaka, IN 46545 Phone: 574-520-1700 Fax: 833-989-0916 | |
Novia Careclinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 Indiana Ave, Mishawaka, IN 46544 Phone: 317-472-7568 Fax: 574-855-1565 | |
Saint Joseph Community Hospital Of Mishawaka, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Lincoln Way W, Mishawaka, IN 46544 Phone: 574-252-3699 Fax: 574-252-3698 | |
Glenn S. Wheet, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 900 Lincoln Way W, Mishawaka, IN 46544 Phone: 574-259-6937 Fax: 574-259-6939 |