Individual provider Active NPI

Eugene Huang, MD

  • Emergency Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1164414173
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01044995 Issued in IN
Practice address
301 E Day Rd
Mishawaka, IN 46545-3455
Phone
(574) 204-7243
Fax
(574) 226-0795
NPI assigned
Aug 16, 2005
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01044995 IN Primary

Addresses

Primary practice location

301 E Day Rd
Mishawaka, IN 46545-3455

Mailing address

211 N Eddy St
South Bend, IN 46617-3096
Phone (574) 234-8161

Other practice location 1

211 N Eddy St
South Bend, IN 46617-3096
Phone (574) 246-8816

Other identifiers 4

IdentifierTypeStateIssuer
103268226MedicaidMI
200102080AMedicaidIN
000000082224OtherINANTHEM
930035898OtherINRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000883 IN Practitioner - Emergency Medicine 3173424363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

301 E Day Rd
Mishawaka, IN 46545-3455
Phone (574) 204-6700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01044995INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Oct 1, 2023 Accepting new patients
The South Bend Clinic, LLC CurrentSince Oct 1, 2023 Accepting new patients
Pic Indiana PC CurrentSince Apr 30, 2013 Accepting new patients
Elite Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Locations

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

900 Johnson St
Elkhart, IN 46514
Phone (574) 747-8004

924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056

301 E Day Rd
Mishawaka, IN 46545
Phone (574) 204-7300

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • Direct secure messaging: ehuang264031@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1164414173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173096",
            "telephone_number": "574-234-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453455",
            "telephone_number": "574-204-7243",
            "fax_number": "574-226-0795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 N Eddy St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466173096",
            "country_code": "US",
            "telephone_number": "574-246-8816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUANG",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01044995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103268226",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200102080A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000082224",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "930035898",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.