Individual provider Active NPI

Sandra A Cho, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • South Bend, IN
National Provider Identifier
1770522989
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07000825A Issued in IN
Practice address
2235 Cleveland Rd
South Bend, IN 46628-3529
Phone
(574) 647-4530
Fax
(574) 647-2285
NPI assigned
Jun 5, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 07000825A IN Primary

Addresses

Primary practice location

2235 Cleveland Rd
South Bend, IN 46628-3529

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other practice location 1

6913 N Main St Ste 300
Granger, IN 46530-8039
Phone (574) 647-1500

Other identifiers 3

IdentifierTypeStateIssuer
000000629532OtherINBCBS BMG MAIN ST
200237740MedicaidIN
P00627888OtherINRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHO@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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070522000285 IN Practitioner - Podiatry 7911004221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1995
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)

2235 Cleveland Rd
South Bend, IN 46628-3529
Phone (574) 647-4530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue109
Removal of skin lesions1-10
Removal of nail tissue70
Removal or shaving of skin growth27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jul 1, 2007 Accepting new patients
Beacon Medical Group, Inc. Foot & Ankle Surgery Current Accepting new patients
Beacon Medical Group, Inc. CurrentSince Jul 1, 2007 Accepting new patients
Northern Indiana Foot & Ankle Assoc Inc Foot & Ankle Surgery Past 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

6913 N Main St
Ste 300
Granger, IN 46530
Phone (574) 647-1500

2235 Cleveland Rd
South Bend, IN 46628
Phone (574) 647-4530

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

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

Interoperability endpoints

  • Direct secure messaging: cho@mybeacon.cernerdirect.com
  • Direct secure messaging: scho1161484@direct.trinity-health.org

Organizations & group practices 6

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1770522989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283529",
            "telephone_number": "574-647-4530",
            "fax_number": "574-647-2285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHO",
        "first_name": "SANDRA",
        "middle_name": "A",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000825A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG MAIN ST",
            "identifier": "000000629532",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200237740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00627888",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHO@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2235 Cleveland Rd",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466283529",
            "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.