Individual provider Active NPI

Robert J Austin, MD

  • Maternal & Fetal Medicine Physician
  • South Bend, IN
National Provider Identifier
1083677439
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
4301033245 Issued in MI
Practice address
615 N Michigan St
South Bend, IN 46601-1033
Phone
(574) 647-1650
Fax
(574) 647-1655
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 20122 WI
Maternal & Fetal Medicine Physician 207VM0101X 01053969A IN
Maternal & Fetal Medicine Physician 207VM0101X 4301033245 MI Primary

Addresses

Primary practice location

615 N Michigan St
South Bend, IN 46601-1033

Mailing address

1428 Forest Dr
Portage, MI 49002-6320
Phone (269) 873-8955

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Other practice location 2

601 John St
Suite N1200
Kalamazoo, MI 49007-5341
Phone (269) 341-7887

Other identifiers 4

IdentifierTypeStateIssuer
4656419MedicaidMI
6062403MedicaidMI
1604114351OtherMIBCBS
1558407189OtherMIGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041207000220 MI Practitioner - Obstetrics/Gynecology 5991761488 Reassigns benefits to 2 organizations
I20210706000796 SD Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 5991761488 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301033245MIMDMaternal & Fetal Medicine Physician
20122WIMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jun 1, 2021 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Maternal & Fetal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Bronson Methodist Hospital Maternal & Fetal Medicine CurrentSince Jan 10, 2007 Accepting new patients
Western Michigan University School of Medicine CurrentSince Dec 1, 2020 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

601 John St
Ste N1200
Kalamazoo, MI 49007
Phone (269) 341-7887

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

1417 S Cliff Ave
Ste 100
Sioux Falls, SD 57105
Phone (605) 322-7580

Interoperability endpoints

  • Direct secure messaging: raustin510540@direct.emplifyhealth.org
  • Direct secure messaging: raustin3293745@direct.trinity-health.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1083677439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 FOREST DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490026320",
            "telephone_number": "269-873-8955",
            "fax_number": "269-324-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-1650",
            "fax_number": "574-647-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 John St",
            "address_2": "Suite N1200",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075341",
            "country_code": "US",
            "telephone_number": "269-341-7887",
            "fax_number": "269-341-6178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WI",
            "license": "20122",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IN",
            "license": "01053969A",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MI",
            "license": "4301033245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4656419",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6062403",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1604114351",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1558407189",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.