Matthew Richard Gillott (NPI# 1447559984, PAC ID# 2567751787) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1447559984 |
| PAC ID by PECOS | 2567751787 |
| Professional Enrollment ID | I20160711001704 |
| Full Name | Matthew Richard Gillott |
| Organization Legal Name | NORTHERN INDIANA MAGNETIC RESONANCE CENTER, LLP |
| Address |
17333 Dugdale Dr South Bend IN 46635-1500 |
| Phone Number | 5742729991 |
| Gender | M |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 6709780802 |
| Number of Group Practice Members | 39 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150012 | SAINT JOSEPH REGIONAL MEDICAL CENTER |
| 151300 | COMMUNITY HOSPITAL OF BREMEN INC |
| 150076 | SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH |
| Address | Phone | Organization |
|---|---|---|
| 121 S Saint Louis Blvd, South Bend, IN 46617-2924 | 2192333123 | X-RAY CONSULTANTS INC |
| 17333 Dugdale Dr, South Bend, IN 46635-1500 | 5742729991 | NORTHERN INDIANA MAGNETIC RESONANCE CENTER, LLP |
| Organization Legal Name | NORTHERN INDIANA MAGNETIC RESONANCE CENTER, LLP |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter Damien Miller | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Vu Nguyen | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 6901 N Main St, Suite 101, Granger, IN 46530-8022 |
| Brett A Stephens | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 611 E Douglas Rd, Suite 122, Mishawaka, IN 46545-1464 |
| Steven T Gerstler | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 6901 N Main St, Suite 101, Granger, IN 46530-8022 |
| Linda L Tuthill | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 611 E Douglas Rd, Suite 122, Mishawaka, IN 46545-1464 |
| Edward L Yang | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 6901 N Main St, Suite 101, Granger, IN 46530-8022 |
| Scott J King | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 611 E Douglas Rd, Suite 122, Mishawaka, IN 46545-1464 |
| Ester Petronella J Van Der Wal | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Ryan B Greene | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 611 E Douglas Rd, Suite 122, Mishawaka, IN 46545-1464 |
| Lyndsay Alexandra Oancea | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Street Address |
17333 DUGDALE DR |
| City | SOUTH BEND |
| State | IN |
| Zip | 46635-1500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter Damien Miller | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Ester Petronella J Van Der Wal | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Lyndsay Alexandra Oancea | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Benjamin L Rase | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Robert J Rust | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael James Oconnell | Family Medicine | 17960 Cleveland Rd, South Bend, IN 46635-1349 | |
| Auna L Preston | Psychologist, Clinical | Samaritan Family Health and Counseling Center, Inc. | 17195 Cleveland Rd, South Bend, IN 46635-1415 |
| Keith Munneke | Clinical Social Worker | Samaritan Family Health and Counseling Center, Inc. | 17195 Cleveland Rd, South Bend, IN 46635-1415 |
| Karen M Zusman | Occupational Therapy | Allied Physicians of Michiana, LLC | 6301 University Commons, Suite 430, South Bend, IN 46635-1416 |
| Sheryl A Vanheesbeke | Physical Therapy | Allied Physicians of Michiana, LLC | 6301 University Commons, South Bend, IN 46635-1416 |
| Thomas James Mango | Orthopedic Surgery | Allied Physicians of Michiana, LLC | 6301 University Commons, Suite 100, South Bend, IN 46635-1416 |
| Douglas D Doctor | Family Medicine | Saint Joseph Regional Medical Center Inc | 17321 State Rd, Suite 23, South Bend, IN 46635-1531 |
| Charles O Higgs Coulthard | Family Medicine | Saint Joseph Regional Medical Center Inc | 17321 State Rd, Suite 23, South Bend, IN 46635-1531 |
| Susan L Conn | Nurse Practitioner | Saint Joseph Regional Medical Center Inc | 17321 State Rd, Suite 23, South Bend, IN 46635-1531 |
| Richard Zentz | Family Medicine | Saint Joseph Regional Medical Center Inc | 17321 State Rd, Suite 23, South Bend, IN 46635-1531 |
| Find all physicians in zip 46635 | |||
| City | SOUTH BEND |
| Zip Code | 46635 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | SOUTH BEND + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.