Individual provider Active NPI

Aroba Sadaf, DO

  • Family Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1689193211
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02006536A Issued in IN
Practice address
4630 Vistula Rd
Mishawaka, IN 46544-4000
Phone
(574) 647-1900
Fax
(574) 647-7289
NPI assigned
Sep 14, 2017
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02006536A IN Primary
Family Medicine Physician 207Q00000X 71359-21 WI

Addresses

Primary practice location

4630 Vistula Rd
Mishawaka, IN 46544-4000

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-1840

Other practice location 1

2102 N Main St
Nappanee, IN 46550-9310
Phone (574) 862-2165

Other identifiers 1

IdentifierTypeStateIssuer
300054667MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asadaf@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
I20211027001526 IN Practitioner - Family Practice 7618398777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

4630 Vistula Rd
Mishawaka, IN 46544-4000
Phone (574) 647-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02006536AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group Inc CurrentSince Nov 1, 2021 Accepting new patients
Beacon Medical Group, Inc. Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

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

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

4630 Vistula Rd
Mishawaka, IN 46544
Phone (219) 254-7200

2102 N Main St
Nappanee, IN 46550
Phone (574) 862-2165

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

Interoperability endpoints

  • Direct secure messaging: asadaf@mybeacon.cernerdirect.com

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 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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1689193211",
    "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": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 VISTULA RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444000",
            "telephone_number": "574-647-1900",
            "fax_number": "574-647-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2102 N Main St",
            "address_purpose": "LOCATION",
            "city": "Nappanee",
            "state": "IN",
            "postal_code": "465509310",
            "country_code": "US",
            "telephone_number": "574-862-2165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADAF",
        "first_name": "AROBA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02006536A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71359-21",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300054667",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asadaf@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2102 N Main St",
            "city": "Nappanee",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465509310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.