Active NPI
Desire M Andersen, M.D.
- Pediatrics Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301103974
- Practice address
- 615 N Michigan St FL 5
South Bend, IN 46601-1033 - Phone
- (574) 647-7275
- Fax
- (574) 647-3696
- NPI assigned
- May 14, 2010
- Last updated
- Jun 29, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301103974 | MI | Primary |
Addresses
Primary practice location
615 N Michigan St FL 5
South Bend, IN 46601-1033
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093033029 | Medicaid | MI | |
| 300089479 | Medicaid | IN |
Other names 1
- Desire M Hurst
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Medical Practices | Current | Accepting new patients | |
| Lakeland Medical Practices | Current | Accepting new patients | |
| Lakeland Hospitals at Niles and St Joseph, Inc | Past | Accepting new patients |
Locations
31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
5515 Cleveland Ave
Stevensville, MI 49127
Phone (269) 429-9644
Interoperability endpoints
- dandersen1268310@epic00.corewelldirect.org
- dhurst16648@lakeland.midirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Corewell Health Medical Group South
- Internal Medicine Physician
- Saint Joseph, MI
- NPI 1538397120
-
dba Corewell Health Medical Group South
- Internal Medicine Physician
- Bridgman, MI
- NPI 1568232247
-
dba Corewell Health Lakeland Hospitals
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1093033029",
"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": "615 N MICHIGAN ST FL 5",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011033",
"telephone_number": "574-647-7275",
"fax_number": "574-647-3696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "DESIRE",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-14",
"last_updated": "2026-06-29",
"certification_date": "2026-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301103974",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093033029",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300089479",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DESIRE",
"last_name": "HURST",
"middle_name": "M",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in South Bend, IN
- Ambulance Enterprises, Inc D/B/a Indiana EMS (Indiana EMS)
- Ambulatory Care Solutions
- American Current Care P.a. (Concentra Urgent Care)
- American Limb & Orthopedic Co
- Rachael Elizabeth Amor, MASTERS IN SOCIAL WO
- Aliyah Anderson, MSW
- Danielle Anderson, RBT
- Hunter Anderson, RBT
- Keith A Anderson, MSW
- Kevin C Anderson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.