Individual provider Active NPI

Christopher John Eberle, DPM

  • Podiatrist
  • Mishawaka, IN
National Provider Identifier
1689200552
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001422A Issued in IN
Practice address
301 E Day Rd
Mishawaka, IN 46545-3455
Phone
(574) 237-9338
NPI assigned
Mar 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07001422A IN Primary

Addresses

Primary practice location

301 E Day Rd
Mishawaka, IN 46545-3455

Mailing address

301 E Day Rd
Mishawaka, IN 46545-3455
Phone (574) 237-9338

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518001856 IN Practitioner - Podiatry 4082036132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue220
Removal of skin lesions1-10
Removal of nail tissue145
Removal or shaving of skin growth13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001422AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic, LLC CurrentSince Jul 1, 2023 Accepting new patients
The South Bend Clinic LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

301 E Day Rd
Mishawaka, IN 46545
Phone (574) 204-7300

611 E Douglas Rd
Ste 101
Mishawaka, IN 46545
Phone (574) 335-6800

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

Interoperability endpoints

  • Direct secure messaging: ceberle1147781@direct.trinity-health.org
  • Direct secure messaging: ceberle262757@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 2

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 2

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": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1689200552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453455",
            "telephone_number": "574-237-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453455",
            "telephone_number": "574-237-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001422A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.