Individual provider Active NPI

Jared Ray Dhaemers, MD

  • Pediatrics Physician
  • Elkhart, IN
National Provider Identifier
1770533424
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01061757A Issued in IN
Practice address
1627 E Bristol St
Elkhart, IN 46514-3817
Phone
(574) 262-0313
Fax
(574) 262-8163
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01061757A IN Primary

Addresses

Primary practice location

1627 E Bristol St
Elkhart, IN 46514-3817

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-1610

Other practice location 1

2120 Rieth Blvd Ste 200
Goshen, IN 46526-5867
Phone (574) 262-0313

Other practice location 2

2606 Peddlers Village Rd Ste 218
Goshen, IN 46526-1004
Phone (574) 262-0313

Other identifiers 1

IdentifierTypeStateIssuer
200818270MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdhaemers@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
I20140425001880 IN Practitioner - Pediatric Medicine 9436382595 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Apr 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Pediatrics CurrentSince Apr 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1627 E Bristol St
Elkhart, IN 46514
Phone (574) 262-0313

2606 Peddlers Village Rd
Ste 218
Goshen, IN 46526
Phone (574) 262-0313

2120 Rieth Blvd
Ste 200
Goshen, IN 46526
Phone (574) 262-0313

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

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1770533424",
    "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": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143817",
            "telephone_number": "574-262-0313",
            "fax_number": "574-262-8163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Rieth Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265867",
            "country_code": "US",
            "telephone_number": "574-262-0313",
            "fax_number": "574-262-8163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2606 Peddlers Village Rd Ste 218",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465261004",
            "country_code": "US",
            "telephone_number": "574-262-0313",
            "fax_number": "574-262-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHAEMERS",
        "first_name": "JARED",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01061757A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200818270",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdhaemers@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2120 Rieth Blvd Ste 200",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465265867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.