Unknown Individual – Surgery Physician, NPI 1780678102
Surgery Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1355 Mariners Dr
Warsaw, IN 465827145
Phone: (574) 535-9100
Fax: (574) 535-1020
Type: Location
1020 High Rd
Bremen, IN 465061093
Phone: (574) 535-9100
Fax: (574) 535-1020
Type: Location
2006, South Main Street, Historic Racemere Peninsula, Goshen, Elkhart County, Indiana, 46526, United States
STUITE A
GOSHEN, IN 465265232
Phone: (574) 535-9100
Fax: (574) 535-1020
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 | 96 | 64 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 61 | 41 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 45 | 44 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 43 | 43 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 29 | 29 | $0 |
Insurance plans in this area (ZIP 46582)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Physician Assistant | IN | |
| General Surgery | IN | |
| Nurse Practitioner | IN | |
| General Surgery | IN | |
| General Surgery | IN | |
| General Surgery | IN | |
| - | IN |
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