Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1891989539 Individual Practitioner Female Practitioner

Dr. Amanda Kathrine Willems Dutkiewicz , MD

Pediatrics • South Bend, IN

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Amanda Dutkiewicz, MD is a registered healthcare professional specializing in Pediatrics in South Bend, IN. Official NPI practice address is registered at 615 N MICHIGAN ST.

Practice Location & Contact Primary Location

Practice Address

615 N Michigan St
5th Fl

South Bend, IN 466011033

Telephone 5746477275
Fax 5746473696
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in South Bend, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.3 Yrs
State Avg: 19.8 Yrs
Regional Practice Density
27 Specialists

Practicing in South Bend, IN (1179 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-04-28
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 01063419A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200886800 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Megan Conway , MD

Pediatrics - Pediatric Critical Care Medicine

NPI 1063895845

Doctor of Medicine (M.D.)

NPI 1093033029

Doctor of Medicine (M.D.)

Dr. Hari Gourabathini , MD

Pediatrics - Pediatric Critical Care Medicine

NPI 1184012130

Doctor of Medicine (M.D.)

NPI 1215179643

Doctor of Medicine (M.D.)

NPI 1215322052

Doctor of Osteopathic Medicine (D.O.)

Siarhei Slinko

Pediatrics - Pediatric Critical Care Medicine

NPI 1356507636

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location April 28, 2023

Registered at 615 N MICHIGAN ST, 5TH FL, SOUTH BEND, IN 466011033 (Tel: 5746477275)

📍
Updated Practice Location April 01, 2021

Registered at 615 N MICHIGAN ST FL 5, SOUTH BEND, IN 466011033 (Tel: 5746477275)

NPI Profile Active June 07, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 07, 2017

Registered at 615 N MICHIGAN ST, 6TH FLOOR, SOUTH BEND, IN 466011033 (Tel: 5746477426)

📍
Updated Business Mailing Address June 07, 2017

Registered at 710 N NILES AVE, SOUTH BEND, IN 466171924 (Tel: 5746471610)

👤
Provider Name / Credentials Updated June 07, 2017

Recorded as AMANDA DUTKIEWICZ, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2017

Pediatrics (License #01063419A in IN)

NPI Profile Active March 08, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location March 08, 2016

Registered at 615 N MICHIGAN ST, 6TH FLOOR, SOUTH BEND, IN 466011033 (Tel: 5746477426)

📍
Updated Business Mailing Address March 08, 2016

Registered at 710 N NILES AVE, SOUTH BEND, IN 466171924 (Tel: 5746471610)

👤
Provider Name / Credentials Updated March 08, 2016

Recorded as AMANDA DUTKIEWICZ, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 08, 2016

Pediatrics (License #01063419A in IN)

🟢
Initial NPI Registration & Enumeration September 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891989539
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 05, 2007
Last Update: April 28, 2023
Sole Proprietor: No

Mailing Address

710 N Niles Ave

South Bend, IN 466171924

Phone: 5746471610

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.