Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin R Ericson, MD

Individual provider Family Medicine Physician · NPI 1265458749

Kevin R Ericson, MD is a Family Practice in Mishawaka, Indiana. Graduated from University of Wisconsin School of Medicine in 1986, 40 years ago. Practices with Saint Joseph Regional Medical Center-South Bend Campus Inc, a 67-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
40
Trained at
University of Wisconsin School of Medicine
Licensed in
IN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1464
Phone: (574) 335-6500
Fax: (574) 335-0772
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01046492 (IN)

Record details

NPI number1265458749
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 15, 2006
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026
Mailing address611 E Douglas Rd Ste 407, Mishawaka, IN 46545-1468

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 1986 (40 years in practice)
Group practice Saint Joseph Regional Medical Center-South Bend Campus Inc — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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