Hubert Fornalik, MD - Medicare Gynecological Oncology in Mishawaka, IN

Hubert Fornalik, MD is a medicare enrolled "Obstetrics & Gynecology - Gynecologic Oncology" physician in Mishawaka, Indiana. He graduated from medical school in 2000 and has 24 years of diverse experience with area of expertise as Gynecological Oncology. He is a member of the group practice Community Care Network Inc, Lutheran Medical Group Llc, Northwest Cancer Centers, P.c., The Methodist Hospitals Inc and his current practice location is 5340 Holy Cross Pkwy, Mishawaka, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 237-1328.

Hubert Fornalik is licensed to practice in Indiana (license number 01067752A) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1255549812.

Contact Information

Hubert Fornalik, MD
5340 Holy Cross Pkwy,
Mishawaka, IN 46545-1470
(574) 237-1328
Not Available



Physician's Profile

Full NameHubert Fornalik
GenderMale
SpecialityGynecological Oncology
Experience24 Years
Location5340 Holy Cross Pkwy, Mishawaka, Indiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Hubert Fornalik graduated from medical school in 2000
  NPI Data:
  • NPI Number: 1255549812
  • Provider Enumeration Date: 05/18/2007
  • Last Update Date: 05/20/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 8224119128
  • Enrollment ID: I20100730000661

Medical Identifiers

Medical identifiers for Hubert Fornalik such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255549812NPI-NPPES
200978000MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 37108 (Iowa)Secondary
207V00000XObstetrics & Gynecology 01067752A (Indiana)Secondary
207V00000XObstetrics & Gynecology MT181806 (Pennsylvania)Secondary
207VX0201XObstetrics & Gynecology - Gynecologic Oncology 01067752A (Indiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Community HospitalMunster, INHospital
Lutheran Hospital Of IndianaFort wayne, INHospital
St Mary Medical Center IncHobart, INHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Community Care Network Inc3678737012360
Lutheran Medical Group Llc4981751617261
Northwest Cancer Centers, P.c.458755347424
The Methodist Hospitals Inc963806389489

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Hubert Fornalik allows following entities to bill medicare on his behalf.
Entity NameThe Methodist Hospitals Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124283858
PECOS PAC ID: 9638063894
Enrollment ID: O20040303000549

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Entity NameNorthwest Cancer Centers, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578527826
PECOS PAC ID: 4587553474
Enrollment ID: O20040310001213

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Entity NameLutheran Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164662805
PECOS PAC ID: 4981751617
Enrollment ID: O20090414000705

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Entity NameCommunity Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457610487
PECOS PAC ID: 3678737012
Enrollment ID: O20120614000331

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Hubert Fornalik is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Hubert Fornalik, MD
100 E Wayne St Ste 510,
South Bend, IN 46601-2394

Ph: (574) 334-5400
Hubert Fornalik, MD
5340 Holy Cross Pkwy,
Mishawaka, IN 46545-1470

Ph: (574) 237-1328

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Obstetrics & Gynecology Doctors in Mishawaka, IN

Asad U. Sheikh, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 611 E Douglas Rd, Suite 408, Mishawaka, IN 46545
Phone: 574-335-6440    Fax: 574-335-0608
Dr. Jodi Carbone,
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 212 W Edison Rd, Suite F, Mishawaka, IN 46545
Phone: 574-257-0621    Fax: 574-257-0641
Katherine Oleary,
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 611 E Douglas Rd Ste 408, Mishawaka, IN 46545
Phone: 574-335-6440    Fax: 574-335-0806
David William Parker, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 611 E Douglas Rd, Suite 408, Mishawaka, IN 46545
Phone: 574-335-6440    Fax: 574-333-5060
Dr. Neil James Sink, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 611 E Douglas Rd Ste 408, Mishawaka, IN 46545
Phone: 574-335-6440    Fax: 574-335-0806

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