Nancy Anne Pudlo, MD - Medicare Pediatrics in Granger, IN

Nancy Anne Pudlo, MD is a medicare enrolled "Pediatrics" physician in Granger, Indiana. Her current practice location is 6913 N Main St Ste 200, Granger, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 647-4540.

Nancy Anne Pudlo is licensed to practice in Indiana (license number 01065123A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1467610352.

Contact Information

Nancy Anne Pudlo, MD
6913 N Main St Ste 200,
Granger, IN 46530-8039
(574) 647-4540
(574) 647-2971



Physician's Profile

Full NameNancy Anne Pudlo
GenderFemale
SpecialityPediatrics
Location6913 N Main St Ste 200, Granger, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1467610352
  • Provider Enumeration Date: 05/28/2008
  • Last Update Date: 03/31/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1456425412
  • Enrollment ID: I20080808000525

Medical Identifiers

Medical identifiers for Nancy Anne Pudlo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467610352NPI-NPPES
000000721926OtherINANTHEM TRADITONAL
200908380MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 01065123A (Indiana)Primary

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. Nancy Anne Pudlo allows following entities to bill medicare on her behalf.
Entity NameBeacon Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033161617
PECOS PAC ID: 1254243306
Enrollment ID: O20031105000657

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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. Nancy Anne Pudlo 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
Nancy Anne Pudlo, MD
710 N Niles Ave,
South Bend, IN 46617-1924

Ph: (574) 647-1610
Nancy Anne Pudlo, MD
6913 N Main St Ste 200,
Granger, IN 46530-8039

Ph: (574) 647-4540

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Pediatrics Doctors in Granger, IN

Mikael Denise Howard,
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 52500 Fir Rd, Granger, IN 46530
Phone: 574-204-7050    Fax: 574-204-7047
Dr. Shanna Verma Kautzmann, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 6913 N Main St Ste 200, Granger, IN 46530
Phone: 574-647-4540    Fax: 574-647-2567
Dr. Charisse D Johnson, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 229 Florence Ave Ste 233, Granger, IN 46530
Phone: 574-855-4575    Fax: 833-314-0410
Dr. Karen D. Davis, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 6913 N Main St, Granger, IN 46530
Phone: 574-647-2970    Fax: 574-647-2971
Dr. Michael James Hudson, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 6913 N Main St, Granger, IN 46530
Phone: 574-647-1500    Fax: 574-243-4343
Melissa Anne Hickey, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 52500 Fir Rd, Granger, IN 46530
Phone: 574-271-0700    Fax: 574-273-5648

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