Individual provider Active NPI

Samuel Benjamin Huxley, MD

  • Interventional Cardiology Physician
  • South Bend, IN
National Provider Identifier
1023511870
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01097988A Issued in IN
Practice address
610 N Michigan St Ste 400
South Bend, IN 46601-1081
Phone
(574) 647-8120
NPI assigned
Mar 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01097988A IN
Interventional Cardiology Physician 207RI0011X 01097988A IN Primary

Addresses

Primary practice location

610 N Michigan St Ste 400
South Bend, IN 46601-1081

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725

Other practice location 1

3220 Beacon Pkwy Ste 200
Granger, IN 46530-7196
Phone (574) 647-8788

Other practice location 2

576 N Oak Dr
Plymouth, IN 46563-1664
Phone (574) 647-5170

Other practice location 3

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-4198

Other practice location 4

900 I St Ste 100
LA Porte, IN 46350-5533
Phone (219) 324-1700

Other practice location 5

1020 High Rd
Bremen, IN 46506-1093
Phone (574) 309-9967

Other practice location 6

202 Lincolnway E Ste 201
Mishawaka, IN 46544-2079
Phone (574) 584-2812

Other identifiers 1

IdentifierTypeStateIssuer
300121696MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030002712 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 2961751250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Medical College of Wisconsin, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

610 N Michigan St
400 BMG Adv Cardiology Specialists
South Bend, IN 46601-1081
Phone (574) 647-8120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68679MNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Cardiovascular Disease CurrentSince Dec 18, 2025 Accepting new patients
Beacon Medical Group Inc CurrentSince Dec 18, 2025 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3220 Beacon Pkwy
Ste 200
Granger, IN 46530
Phone (574) 647-8788

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

900 I St
#100
Laporte, IN 46350
Phone (219) 324-1730

900 I St
Laporte, IN 46350
Phone (219) 324-1670

202 Lincolnway E
Ste 201
Mishawaka, IN 46544
Phone (574) 584-2812

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

610 N Michigan St
Ste 400
South Bend, IN 46601
Phone (574) 204-7333

Interoperability endpoints

  • Direct secure messaging: shuxley2128505@epic00.corewelldirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1023511870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N MICHIGAN ST STE 400",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011081",
            "telephone_number": "574-647-8120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 Beacon Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465307196",
            "country_code": "US",
            "telephone_number": "574-647-8788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "576 N Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465631664",
            "country_code": "US",
            "telephone_number": "574-647-5170",
            "fax_number": "574-647-5183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-4198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I St Ste 100",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 High Rd",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061093",
            "country_code": "US",
            "telephone_number": "574-309-9967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Lincolnway E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465442079",
            "country_code": "US",
            "telephone_number": "574-584-2812",
            "fax_number": "574-584-2813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUXLEY",
        "first_name": "SAMUEL",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01097988A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01097988A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300121696",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.