Active NPI
Eduardo Campos-Hernandez, PT
- Physical Therapist
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05016233A
- Practice address
- 202 Lincolnway E Ste 100
Mishawaka, IN 46544-2079 - Phone
- (574) 647-2560
- Fax
- (574) 647-2563
- NPI assigned
- Nov 7, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 05016233A | IN | |
| Physical Therapist | 225100000X | 05016233A | IN | Primary |
Addresses
Primary practice location
202 Lincolnway E Ste 100
Mishawaka, IN 46544-2079
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725
Other practice location 1
200 E Jackson Blvd Ste 150
Elkhart, IN 46516-3513
Phone (574) 389-5558
Other practice location 2
3221 Beacon Pkwy Ste 100
Granger, IN 46530-7196
Phone (574) 647-2930
Other practice location 3
111 W Jefferson Blvd Ste 100
South Bend, IN 46601-1993
Phone (574) 647-2600
Other practice location 4
1815 E Ireland Rd Ste 100
South Bend, IN 46614-2845
Phone (574) 647-5790
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300124715 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1815 E Ireland Rd
Suite 100
South Bend, IN 46614-2845
Phone (574) 647-5790
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05016233A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Health, LLC | Physical Therapist | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Past | Accepting new patients | |
| Beacon Health, LLC | Past | Accepting new patients |
Locations
200 E Jackson Blvd
Ste 150
Elkhart, IN 46516
Phone (574) 389-5558
3221 Beacon Pkwy
Ste 100
Granger, IN 46530
Phone (574) 647-2930
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
202 Lincolnway E
Ste 100
Mishawaka, IN 46544
Phone (574) 647-2560
1815 E Ireland Rd
#100
South Bend, IN 46614
Phone (574) 647-5790
Organizations & group practices 3
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.
-
- Physical Therapist
- Granger, IN
- NPI 1386154821
-
- Diagnostic Radiology Physician
- Goshen, IN
- NPI 1952982217
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1073483715",
"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": "202 LINCOLNWAY E STE 100",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465442079",
"telephone_number": "574-647-2560",
"fax_number": "574-647-2563"
}
],
"practiceLocations": [
{
"address_1": "200 E JACKSON BLVD STE 150",
"address_purpose": "LOCATION",
"city": "ELKHART",
"state": "IN",
"postal_code": "465163513",
"country_code": "US",
"telephone_number": "574-389-5558",
"fax_number": "574-389-5559",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3221 Beacon Pkwy Ste 100",
"address_purpose": "LOCATION",
"city": "Granger",
"state": "IN",
"postal_code": "465307196",
"country_code": "US",
"telephone_number": "574-647-2930",
"fax_number": "574-647-2935",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 W Jefferson Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011993",
"country_code": "US",
"telephone_number": "574-647-2600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1815 E Ireland Rd Ste 100",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466142845",
"country_code": "US",
"telephone_number": "574-647-5790",
"fax_number": "574-647-5792",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAMPOS-HERNANDEZ",
"first_name": "EDUARDO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-07",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IN",
"license": "05016233A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05016233A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300124715",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
- 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.