Individual provider Active NPI

John S Gilbert, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Mishawaka, IN
National Provider Identifier
1275735581
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
02004142A Issued in IN
Practice address
810 Park Place
Mishawaka, IN 46545
Phone
(574) 366-0240
Fax
(574) 366-0218
NPI assigned
May 31, 2007
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 02004142A IN Primary

Addresses

Primary practice location

810 Park Place
Mishawaka, IN 46545

Mailing address

810 Park Place
Mishawaka, IN 46545
Phone (574) 366-0240

Other practice location 1

6913 N Main St
Ste 200
Granger, IN 46530-8039
Phone (574) 647-4540

Other practice location 2

1753 Fulton St
Elkhart, IN 46514-1927
Phone (574) 293-9448

Other practice location 3

2222 Rieth Blvd
Suite 104
Goshen, IN 46526-5869
Phone (574) 875-1082

Other practice location 4

6913 N Main St
Ste 300
Granger, IN 46530-8039
Phone (574) 647-1500

Other identifiers 1

IdentifierTypeStateIssuer
201134970MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GILBERT@mybeacon.cernerdirect.com

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
I20130510000191 IN Practitioner - Otolaryngology 2961534615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio University, College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians
Exhale Sinus Indiana Clinics LLCGroup PAC ID 1254834088, 3 clinicians

Practice addresses (Care Compare)

1753 Fulton St
Elkhart, IN 46514-1927
Phone (574) 293-9448

2222 Rieth Blvd
Goshen, IN 46526-5869

600 E Blvd
Elkhart, IN 46514-2483

600 E Blvd 4TH FL Hospitalists
BMG Hospital Specialties
Elkhart, IN 46514-2483
Phone (574) 647-3050

6913 N Main St
Granger, IN 46530-8039

810 Park PL
Mishawaka, IN 46545-3520
Phone (574) 366-0240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004142AINMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Exhale Sinus Indiana Clinics LLC CurrentSince Aug 3, 2025 Accepting new patients
Archbold Medical Group, Inc. Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

6913 N Main St
Ste 200
Granger, IN 46530
Phone (574) 647-4540

6913 N Main St
Ste 300
Granger, IN 46530
Phone (574) 647-1500

810 Park Pl
Mishawaka, IN 46545
Phone (574) 336-0240

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Interoperability endpoints

  • Direct secure messaging: gilbert@mybeacon.cernerdirect.com
  • Direct secure messaging: jgilbert@mybeacon.cernerdirect.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1275735581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 PARK PLACE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-366-0240",
            "fax_number": "574-366-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 PARK PLACE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-366-0240",
            "fax_number": "574-366-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-4540",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1753 Fulton St",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465141927",
            "country_code": "US",
            "telephone_number": "574-293-9448",
            "fax_number": "574-293-9480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-1082",
            "fax_number": "574-875-3860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6913 N Main St",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IN",
            "license": "02004142A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201134970",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GILBERT@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1753 Fulton St",
            "city": "Elkhart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465141927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.