Individual provider Active NPI

Howard John Halstead, M.D.

  • Orthopaedic Surgery Physician
  • South Bend, IN
National Provider Identifier
1750496618
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01030046 Issued in IN
Practice address
211 N Eddy St
South Bend, IN 46617-2808
Phone
(574) 237-9294
Fax
(574) 237-9259
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01030046 IN Primary

Addresses

Primary practice location

211 N Eddy St
South Bend, IN 46617-2808

Mailing address

211 N Eddy Street
South Bend, IN 46617-2808
Phone (574) 237-9294

Other identifiers 1

IdentifierTypeStateIssuer
100149660AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01030046INMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Medical Group, Inc. Orthopaedic Surgery PastSince Jun 1, 2003 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hhalstead2543197@direct.trinity-health.org

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1750496618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY STREET",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-237-9294",
            "fax_number": "574-237-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-237-9294",
            "fax_number": "574-237-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "HOWARD",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01030046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100149660A",
            "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 Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.