Individual provider Active NPI

Howard Elvindo Wiarda, MD

  • Vascular & Interventional Radiology Physician
  • South Bend, IN
National Provider Identifier
1801881255
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
01052406 Issued in IN
Practice address
100 Navarre PL Ste 5500
South Bend, IN 46601-1172
Phone
(574) 647-5200
Fax
(574) 647-5210
NPI assigned
Sep 13, 2005
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 01052406 IN
Therapeutic Radiology Physician 2085R0203X 01052406 IN
Vascular & Interventional Radiology Physician 2085R0204X 01052406 IN Primary
Diagnostic Ultrasound Physician 2085U0001X 01052406 IN

Addresses

Primary practice location

100 Navarre PL Ste 5500
South Bend, IN 46601-1172

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
200261430MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hwiarda@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
I20040209001222 IN Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0042104317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 1994
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)

100 Navarre PL
5500 BMG Interventional Radiology
South Bend, IN 46601-1172
Phone (574) 647-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01052406INMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jun 25, 2018 Accepting new patients
Beacon Medical Group, Inc. Vascular & Interventional Radiology CurrentSince Jun 25, 2018 Accepting new patients
Radiology, Inc Body Imaging Past Accepting new patients
Memorial Lighthouse Imaging LLC Body Imaging Past Accepting new patients
Beacon Medical Group, Inc. Vascular & Interventional Radiology Past Accepting new patients

Locations

1020 High Rd
#O
Bremen, IN 46506
Phone (574) 284-3086

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

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

900 I St
Laporte, IN 46350
Phone (219) 324-1670

100 Navarre Pl
Ste 5500
South Bend, IN 46601
Phone (574) 647-5200

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

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

621 Memorial Dr
Ste 312
South Bend, IN 46601
Phone (574) 647-5200

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

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 4

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1801881255",
    "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": "100 NAVARRE PL STE 5500",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011172",
            "telephone_number": "574-647-5200",
            "fax_number": "574-647-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIARDA",
        "first_name": "HOWARD",
        "middle_name": "ELVINDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IN",
            "license": "01052406",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "IN",
            "license": "01052406",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01052406",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IN",
            "license": "01052406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200261430",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwiarda@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl Ste 5500",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011172",
            "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.