Sara Bajuyo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01060961A Issued in IN

Practice address

620 W Edison Rd Ste 132
Mishawaka, IN 46545-2784

Phone

(574) 369-6393

Fax

(574) 261-3129

NPI assigned

Jul 7, 2006

Last updated

Feb 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Oct 1, 2024 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1346273117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W EDISON RD STE 132",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452784",
            "telephone_number": "574-369-6393",
            "fax_number": "574-261-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W EDISON RD STE 132",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452784",
            "telephone_number": "574-369-6393",
            "fax_number": "574-261-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJUYO",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060961A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "146470D8",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avenues Recovery Center at South Bend LLC
• Brianne Noel Avery, DC
• Kelli Jo-Ann Bacon
• Adell Badgett II
• Jean Bahu, FNP-BC
• Diana Bakia, MA
• Eusebia Balderas
• Robert Balliet, MSW
• Carol Ann Banks, R.N.
• Latisha Banks, LCSW

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.