Individual provider Active NPI

Abbie Elaine Maes, NP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1336935816
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71017183A Issued in IN
Practice address
621 Memorial Dr Ste 502
South Bend, IN 46601-1075
Phone
(574) 647-5875
Fax
(574) 647-5878
NPI assigned
Apr 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71017183A IN Primary

Addresses

Primary practice location

621 Memorial Dr Ste 502
South Bend, IN 46601-1075

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2713

Other practice location 1

500 Arcade Ave Ste 320
Elkhart, IN 46514-2477
Phone (574) 523-7900

Other identifiers 1

IdentifierTypeStateIssuer
300121720MedicaidIN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022001335 IN Practitioner - Nurse Practitioner 1052809076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

621 Memorial Dr
Suite 502
South Bend, IN 46601-1075
Phone (574) 647-5875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71017183AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Inc CurrentSince Nov 2, 2025 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Nov 2, 2025 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients

Locations

500 Arcade Ave
Ste 320
Elkhart, IN 46514
Phone (574) 293-3317

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

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

621 Memorial Dr
Ste 502
South Bend, IN 46601
Phone (574) 234-9001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1336935816",
    "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": "574-647-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 502",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011075",
            "telephone_number": "574-647-5875",
            "fax_number": "574-647-5878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Arcade Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142477",
            "country_code": "US",
            "telephone_number": "574-523-7900",
            "fax_number": "574-523-7909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAES",
        "first_name": "ABBIE",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-19",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71017183A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300121720",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.