Active NPI
John S Gilbert, D.O.
- Otolaryngology/Facial Plastic Surgery Physician
- Mishawaka, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- License
- 02004142A
- 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, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201134970 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02004142A | IN | MD | Otolaryngology/Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Exhale Sinus Indiana Clinics LLC | Current | 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
- gilbert@mybeacon.cernerdirect.com
- 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.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Otolaryngology Physician
- Mishawaka, IN
- NPI 1386535243
-
dba Beacon Medical Group Wakarusa
- Family Medicine Physician
- Wakarusa, IN
- NPI 1184641706
-
- Surgery Physician
- Thomasville, GA
- NPI 1831353036
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.
- 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.