Active NPI
Robert T Raster, MD
- Psychiatry Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01045140
- Practice address
- 403 E Madison St
South Bend, IN 46617-2322 - Phone
- (574) 234-0061
- Fax
- (574) 283-1209
- NPI assigned
- Mar 3, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01045140 | IN | Primary |
Addresses
Primary practice location
403 E Madison St
South Bend, IN 46617-2322
Mailing address
403 E Madison St
South Bend, IN 46617-2322
Phone (574) 234-0061
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200103420A | Medicaid | IN |
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
- Psychiatry
- Education
- Wayne State University School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 N Oak Dr
Plymouth, IN 46563-3406
Phone (574) 303-5375
221 Red Coach Dr E
Behavioral Health
Mishawaka, IN 46545-8324
Phone (574) 335-7630
301 W Homer St
Michigan City, IN 46360-4358
Phone (219) 879-8511
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01045140 | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Regional Medical Center, Inc. | Psychiatry | Current | Accepting new patients |
| Saint Joseph Regional Medical Center, Inc. | Current | Accepting new patients | |
| South Bend Psychiatry LLC | Psychiatry | Current | Accepting new patients |
| HHC Indiana Inc. | Past | Accepting new patients | |
| Aims-Med, LLC | Past | Accepting new patients |
Locations
1012 W Indiana St
Kouts, IN 46347
Phone (219) 766-2999
301 W Homer St
Michigan City, IN 46360
Phone (219) 877-1033
60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500
5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443
611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232
221 Red Coach Dr
Ste E
Mishawaka, IN 46545
Phone (574) 335-7630
1800 N Oak Dr
Plymouth, IN 46563
Phone (574) 303-5375
2349 Lake Ave
Ste 100
Plymouth, IN 46563
Phone (574) 941-3111
403 E Madison St
South Bend, IN 46617
Phone (574) 234-0061
616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100
Interoperability endpoints
- rraster1147644@direct.trinity-health.org
- rraster171465@direct.franciscanalliance.org
Organizations & group practices 5
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.
-
- Pulmonary Disease Physician
- Plymouth, IN
- NPI 1225082878
Psychiatry
-
- Psychiatry Physician
- Plymouth, IN
- NPI 1700112224
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1467406074
-
- Internal Medicine Physician
- Bremen, IN
- NPI 1881211878
-
- Psychiatric Hospital
- Plymouth, IN
- NPI 1801822440
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- La Porte, IN
- NPI 1679336747
-
- General Acute Care Hospital
- Michigan City, IN
- NPI 1710051941
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1023965795
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257120000000",
"number": "1417924879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 E MADISON ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-234-0061",
"fax_number": "574-283-1209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E MADISON ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-234-0061",
"fax_number": "574-283-1209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASTER",
"first_name": "ROBERT",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2009-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01045140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200103420A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.