Individual provider Active NPI

Sonia Yuen, MD

  • Otolaryngology Physician
  • South Bend, IN
National Provider Identifier
1487187894
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01088126A Issued in IN
Practice address
100 Navarre PL Ste 4460
South Bend, IN 46601-1168
Phone
(574) 235-1010
Fax
(574) 232-2064
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 57.030066 OH
Otolaryngology Physician 207Y00000X 01088126A IN Primary

Addresses

Primary practice location

100 Navarre PL Ste 4460
South Bend, IN 46601-1168

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 657-6592

Other practice location 1

1753 Fulton St
Elkhart, IN 46514-1927
Phone (574) 293-9448

Other identifiers 1

IdentifierTypeStateIssuer
300004091MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220809002596 IN Practitioner - Otolaryngology 5890065122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Washington University School of Medicine, 2017
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)

100 Navarre PL
4460 BMG ENT and Audiology South Bend
South Bend, IN 46601-1168
Phone (574) 235-1010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088126AINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. CurrentSince Aug 22, 2022 Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 22, 2022 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1753 Fulton St
Elkhart, IN 46514
Phone (574) 293-9448

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

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

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

100 Navarre Pl
Ste 4460
South Bend, IN 46601
Phone (574) 234-0049

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 4

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1487187894",
    "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": "574-657-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 4460",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011168",
            "telephone_number": "574-235-1010",
            "fax_number": "574-232-2064"
        }
    ],
    "practiceLocations": [
        {
            "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"
        }
    ],
    "basic": {
        "last_name": "YUEN",
        "first_name": "SONIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "57.030066",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01088126A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300004091",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.