NPIMap

Individual provider Active NPI

Shamiram Badal, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1760629307
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A113428 Issued in CA
Practice address
2930 W Cleveland Rd
South Bend, IN 46628-6090
Phone
(574) 335-8450
Fax
(574) 335-0760
NPI assigned
Jan 20, 2009
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125053883 IL
Family Medicine Physician 207Q00000X A113428 CA Primary

Addresses

Primary practice location

2930 W Cleveland Rd
South Bend, IN 46628-6090

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-8700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shamiram.badal@directsjpn.mhin.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121026000374 IN Practitioner - Family Practice 1557542503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2930 W Cleveland Rd Ext
Northwest Family Medicine
South Bend, IN 46628-6090
Phone (574) 335-8450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113428CAMDPediatric Anesthesiology Physician
125053883ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients
Emanuel Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

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

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

2930 W Cleveland Road Ext
South Bend, IN 46628
Phone (574) 335-8450

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

Interoperability endpoints

  • Direct secure messaging: shamiram.badal@directsjpn.mhin.net

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

Hospital & facility affiliations 7

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1760629307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-8700",
            "fax_number": "574-335-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 W CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466286090",
            "telephone_number": "574-335-8450",
            "fax_number": "574-335-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADAL",
        "first_name": "SHAMIRAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125053883",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A113428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shamiram.badal@directsjpn.mhin.net",
            "affiliation": "N",
            "endpointDescription": "my direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd",
            "address_1": "2930 W Cleveland Rd",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466286090",
            "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.