NPIMap

Individual provider Active NPI

Robert Cassady, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1407206824
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01079265A Issued in IN
Practice address
4440 Portage Ave
South Bend, IN 46628-9570
Phone
(574) 204-6200
Fax
(574) 239-1520
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01079265A IN Primary

Addresses

Primary practice location

4440 Portage Ave
South Bend, IN 46628-9570

Mailing address

4440 Portage Ave
South Bend, IN 46628-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180831000722 IN Practitioner - Family PracticePractitioner - Emergency Medicine 2860775848 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

4440 Portage Rd
South Bend, IN 46628-9570
Phone (574) 204-6200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Ecs, Inc Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Eventus Wholehealth Midwest Inc Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
The South Bend Clinic LLC CurrentSince Jul 1, 2019 Accepting new patients
The South Bend Clinic, LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

2100 Midway St
Columbus, IN 47201
Phone 3178181240225

150 W Market St
Ste 400
Indianapolis, IN 46204

714 N Michigan St
South Bend, IN 46601
Phone (574) 647-7477

4440 Portage Rd
South Bend, IN 46628
Phone (574) 204-6200

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

Interoperability endpoints

  • Direct secure messaging: robertcassady@beacon.allscriptsdirect.net
  • Direct secure messaging: rcassady252907@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Holy Cross Village at Notre Dame IncSouth Bend, IN, CCN 155745 Skilled nursing facility Adp of the SNF Aug 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1407206824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 PORTAGE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 PORTAGE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289570",
            "telephone_number": "574-204-6200",
            "fax_number": "574-239-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSADY",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01079265A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.