Privia Medical Group Indiana, LLC
NPI 1235303165 · Multi-Specialty Clinic/Center · Mishawaka, IN
Privia Medical Group Indiana, LLC is a Multi-Specialty Clinic/Center organization in Mishawaka, IN (NPI 1235303165).
Provider details
- NPI number
- 1235303165
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Timothy Porsche, Managing Partner(574) 296-3200
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Edison Lakes Urology
- Other name
- Primary Care at Mishawaka
Registry dates
- Enumerated
- 2008-04-22
- Last updated
- 2025-05-12
- Certified
- 2025-05-12
Frequently asked questions
- What is Privia Medical Group Indiana, LLC's NPI number?
- Privia Medical Group Indiana, LLC's National Provider Identifier (NPI) is 1235303165, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Privia Medical Group Indiana, LLC?
- Privia Medical Group Indiana, LLC is classified in the NPPES registry as Multi-Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is Privia Medical Group Indiana, LLC located?
- Privia Medical Group Indiana, LLC's practice location on file with NPPES is 410 Park Pl, Mishawaka, IN 46545-3557.
- What is Privia Medical Group Indiana, LLC's phone number?
- The practice phone number listed in the NPPES registry for Privia Medical Group Indiana, LLC is (574) 855-5800.
- Who is the authorized official for Privia Medical Group Indiana, LLC?
- The authorized official listed on Privia Medical Group Indiana, LLC's NPPES record is Timothy Porsche, Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Privia Medical Group Indiana, LLC's NPI active?
- Yes — Privia Medical Group Indiana, LLC's NPI (1235303165) is active in the NPPES registry as of the last update on 2025-05-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.