Saint Joseph Regional Medical Center-South Bend Campus, Inc
Organization Active NPI Mobile Mammography Clinic/Center · South Bend, IN
NPI 1023844693 · NPPES record last updated Jan 16, 2025
Key facts
- NPI
- 1023844693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mobile Mammography Clinic/Center 261QR0207X
- Legal business name
- SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC
- Practice address
- 234 Chapin St Ste I
South Bend, IN 46601-2571 - Phone
- (574) 274-4552
- Fax
- (574) 335-0660
- NPI assigned
- Sep 11, 2024
- Organization subpart
- No
Authorized official
- Name
- Christopher James Karam
- Title
- RHM President
- Phone
- (575) 335-5000
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 7
Practitioners 214
-
Roni Aizigov, CRNA, NP-C
-
Jialin Bao, M.D.
-
Robert Beyerlein, CRNA
-
Jay Biesenthal, CRNA
-
Steven Burkett, CRNA
-
Yulong Chen, M.D.
-
John Chung, MD
-
Michele Nicole Collins, M.D.
-
Daniel Curnyn, MD
-
Kevin R Ericson, MD
-
Marcus Farrand, DO
-
Stephanie Drazer Ford, APRN
-
Jordan Geroski, DO
-
Jason R Grove, DPM
-
Lou Ann Hall Matos, DPM
-
Jordan Hatch, MD
-
Blake Hawk, CRNA
-
Charles Higgs-Coulthard, M.D.
-
Bin Hu, M.D.
-
Amanda Marie Huff, DNP, CRNA
-
Kenneth A. Jongsma, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031223000724 | IN | Part B Supplier - Clinic/Group Practice | 3476451790 |
Receives reassigned benefits from 206 practitioners 8 other NPIs on this enrollment Practice locations: Mishawaka, IN; South Bend, IN |
National Provider Directory
- Tax ID family
- St Josephs Med Ctr
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse |
163WC1500X | |||
| Community Health Worker |
172V00000X | |||
| Mammography Radiologic Technologist |
2471M2300X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Mobile Mammography Clinic/Center | 261QR0207X | Yes | ||
| Community Health/Public Health Clinical Nurse Specialist |
364SC1501X |
Addresses
Primary practice location
234 Chapin St Ste I
South Bend, IN 46601-2571
Mailing address
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-8707
Other names
- Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med
Other providers in South Bend, IN
- Heather Saffel
- Nathaniel Douglas Sagarsee
- Ashley Amanda Saia
- Kirsten Sailors
- Christopher Sain
- Saint Joseph Regional Medical Center-South Bend Campus, Inc.
- Saint Joseph Regional Medical Center-South Bend Campus, Inc.
- Saint Jude Offices, LLC
- Yahya Ali Saleh
- Victor Salinas
All providers in South Bend, IN · Mobile Mammography Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.