MINI SRA – Internal Medicine Physician, NPI 1003122003
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
878 HOSPITALIST in IN
Provider Addresses for MINI SRA
5215 HOLY CROSS PKWY
MISHAWAKA, IN 465451469
Phone: (574) 335-2521
Fax: (574) 335-2262
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $354.
Total Amount is formed as General ($354) + Research ($0) + Ownership ($0) = $354.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($182).
Total Amount
$354
General + Research + Ownership
Payments
18
Total payment records
General Amount
$354
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $182 |
| AstraZeneca Pharmaceuticals LP | $55 |
| ABBVIE INC. | $45 |
| Merck Sharp & Dohme LLC | $38 |
| PFIZER INC. | $35 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-11-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131113001394 | I | Hospitalist | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 897 | 316 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 159 | 150 | $0 |
| 99238 | Hospital discharge day management, 30 minutes or less | 129 | 125 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 90 | 89 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 17 | 14 | $0 |
Insurance plans in this area (ZIP 46545)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Physician Assistant | IN | |
| - | NV | |
| Internal Medicine | IN | |
| Internal Medicine | IL | |
| Hospitalist, Internal Medicine, Internal Medicine | NY | |
| Internal Medicine | IN | |
| Internal Medicine, Hospitalist | PA | |
| Nurse Practitioner | WA | |
| - | NJ |
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