MATTHEW R MISNER (D.O.) – Pediatrics Physician, NPI 1366637555
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
101 HOSPICE/PALLIATIVE CARE in IN
Provider Addresses for MATTHEW R MISNER (D.O.)
6913 N Main St Ste 200
Granger, IN 465308039
Phone: (574) 647-4540
Fax: (574) 647-2567
Type: Location
808 N 3rd St
Goshen, IN 465287100
Phone: (574) 534-0088
Fax: (574) 971-8434
Type: Location
213, Middlebury Street, Chamberlain, Goshen, Elkhart County, Indiana, 46528, United States
GOSHEN, IN 465282956
Phone: (574) 534-3300
Fax: (574) 534-5412
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-10-11
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 |
|---|---|---|---|---|
| I20181011002295 | I | Hospice/Palliative Care | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46530)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Physical Medicine And Rehabilitation, Hospice/Palliative Care, Hospitalist | OK | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
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