THOMAS L POULIN (MD) – Vascular Surgery Physician, NPI 1497732556
Vascular Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
729 GENERAL SURGERY in IN
Provider Addresses for THOMAS L POULIN (MD)
North Niles Avenue, South Bend, Saint Joseph County, Indiana, 46617, United States
SOUTH BEND, IN 466171924
Phone: (574) 647-1610
Fax: (574) 237-6069
Type: Mailing
100 NAVARRE PL STE 5500
SOUTH BEND, IN 466011172
Phone: (574) 647-5200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $523.
Total Amount is formed as General ($523) + Research ($0) + Ownership ($0) = $523.
Last reported payment date: 2024-06-04 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($389).
Total Amount
$523
General + Research + Ownership
Payments
3
Total payment records
General Amount
$523
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $389 |
| Medtronic, Inc. | $107 |
| Bard Peripheral Vascular, Inc. | $27 |
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: 2009-12-22
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 |
|---|---|---|---|---|
| I20091222000305 | I | General Surgery | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 146 | 104 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 80 | 72 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 34 | 34 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18 | 15 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 46617)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | IN | 93926 | Ultrasound study of arteries and arterial grafts of one leg or limited | 97 | 75 |
| GENERAL SURGERY | IN | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 52 | 41 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Qualified Audiologist | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| General Surgery | IN | |
| - | IN |
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