Individual provider Active NPI

Haidong Bao, M.D.

  • Internal Medicine Physician
  • South Bend, IN
National Provider Identifier
1578723573
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01068048A Issued in IN
Practice address
615 N Michigan St FL 1
South Bend, IN 46601-1033
Phone
(574) 647-3050
Fax
(574) 647-1094
NPI assigned
Jun 12, 2008
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01068048A IN Primary
Hospitalist Physician 208M00000X 01068048A IN

Addresses

Primary practice location

615 N Michigan St FL 1
South Bend, IN 46601-1033

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725

Other practice location 1

600 East Blvd 4th Floor Hospitalists Ste
Elkhart, IN 46514-2483
Phone (574) 389-7393

Other identifiers 1

IdentifierTypeStateIssuer
200984290MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hbao@mybeacon.cernerdirect.com

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
I20100811000415 IN Practitioner - Internal Medicine 4183758287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
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)

615 N Michigan St FL
1 Beacon Medical Group Hospital Spec
South Bend, IN 46601-1033
Phone (574) 647-3050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01068048AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Mar 1, 2017 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Mar 1, 2017 Accepting new patients
Major Hospital Past Accepting new patients

Locations

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

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

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1578723573",
    "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": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST FL 1",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-3050",
            "fax_number": "574-647-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 East Blvd 4th Floor Hospitalists Ste",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142483",
            "country_code": "US",
            "telephone_number": "574-389-7393",
            "fax_number": "574-647-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAO",
        "first_name": "HAIDONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01068048A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01068048A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200984290",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbao@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "615 N Michigan St Fl 1",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.