Riley Graber, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

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

Phone

(574) 647-8120

Fax

(574) 647-8111

NPI assigned

Nov 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1043036023",
    "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",
            "fax_number": "574-647-8111"
        }
    ],
    "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",
            "fax_number": "574-647-3321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 N Michigan St Ste 306",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011079",
            "country_code": "US",
            "telephone_number": "574-647-6500",
            "fax_number": "574-647-6518",
            "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"
        },
        {
            "address_1": "1020 High Rd",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061093",
            "country_code": "US",
            "telephone_number": "574-309-9967",
            "fax_number": "574-309-9968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRABER",
        "first_name": "RILEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300131065",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Gorski, BCABA, NCC
• Andrew Goul, D.C.
• Brigette M Goulet, MSOM
• Hari Rasad Gourabathini, M.D
• Katherine Delayne Goze
• Grace Hospice of Indiana, LLC
• Mindy Lynne Gradeless, MSW
• Deshannon Grady Jr
• Miriam Amy Grady
• Bob H Graf, O.D.

• Physician Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.