Alice Catherine Shaw, FNP - Medicare Nurse Practitioner in South Bend, IN

Alice Catherine Shaw, FNP is a medicare enrolled "Nurse Practitioner - Family" in South Bend, Indiana. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice The South Bend Clinic Llc and her current practice location is 4440 N Portage Ave, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 204-6200.

Alice Catherine Shaw is licensed to practice in Indiana (license number 71010179A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063020279.

Contact Information

Alice Catherine Shaw, FNP
4440 N Portage Ave,
South Bend, IN 46628-9570
(574) 204-6200
Not Available



Provider's Profile

Full NameAlice Catherine Shaw
GenderFemale
SpecialityNurse Practitioner
Experience4 Years
Location4440 N Portage Ave, South Bend, Indiana
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Alice Catherine Shaw graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1063020279
  • Provider Enumeration Date: 07/14/2020
  • Last Update Date: 05/24/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3274916994
  • Enrollment ID: I20220812002504

Medical Identifiers

Medical identifiers for Alice Catherine Shaw such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063020279NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 71010179A (Indiana)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The South Bend Clinic Llc3779577937174

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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. Alice Catherine Shaw allows following entities to bill medicare on her behalf.
Entity NameThe South Bend Clinic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073680419
PECOS PAC ID: 3779577937
Enrollment ID: O20040412000439

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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. Alice Catherine Shaw 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
Alice Catherine Shaw, FNP
4440 N Portage Ave,
South Bend, IN 46628

Ph: () -
Alice Catherine Shaw, FNP
4440 N Portage Ave,
South Bend, IN 46628-9570

Ph: (574) 204-6200

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Nurse Practitioner Nurses in South Bend, IN

Beth Ann Hayden, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 707 N Michigan St, Ste 400, South Bend, IN 46601
Phone: 574-647-8470    Fax: 574-647-8475
Rachel Ann Jennings, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 615 N Michigan St, South Bend, IN 46601
Phone: 574-647-1000    
Kelly Mae Losiniecki, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 211 N Eddy St., South Bend, IN 46617
Phone: 574-237-9231    Fax: 574-204-6355
Mrs. Brandice Lynn Page, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 53760 Generations Dr, South Bend, IN 46635
Phone: 888-938-3838    Fax: 888-919-1083
Gina M. Connolly, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 100 Navarre Pl Ste 6600, South Bend, IN 46601
Phone: 574-647-8800    Fax: 574-647-8811
Amanda Lundberg, MSN, RN, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 53830 Generations Dr Ste 110, South Bend, IN 46635
Phone: 574-234-2191    
Kendall Hochstedler,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1960 Northside Blvd, South Bend, IN 46615
Phone: 574-307-7673    Fax: 574-234-4706

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