Individual provider Active NPI

Betsy Rossow, MD

  • Hospitalist Physician
  • South Bend, IN
National Provider Identifier
1841247095
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01056756A Issued in IN
Practice address
615 N Michigan St FL 5
South Bend, IN 46601-1033
Phone
(574) 647-7275
Fax
(574) 647-3696
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01056756A IN
Pediatrics Physician 208000000X 4301083379 MI
Hospitalist Physician 208M00000X 01056756A IN Primary

Addresses

Primary practice location

615 N Michigan St FL 5
South Bend, IN 46601-1033

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-6592

Other identifiers 1

IdentifierTypeStateIssuer
200907100MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brossow@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
I20200324000672 IN Practitioner - Pediatric Medicine 4183052236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056756AINMDPediatrics Physician
4301083379MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Pediatric Critical Care Medicine CurrentSince Mar 1, 2020 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

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

615 N Michigan St
Fl 6
South Bend, IN 46601
Phone (574) 647-6892

615 N Michigan St
Fl 5
South Bend, IN 46601
Phone (574) 647-7275

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

100 Navarre Pl
Ste 5550
South Bend, IN 46601
Phone (574) 234-5123

Organizations & group practices 3

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1841247095",
    "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": "574-647-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST FL 5",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-7275",
            "fax_number": "574-647-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSOW",
        "first_name": "BETSY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01056756A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301083379",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01056756A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200907100",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brossow@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "615 N Michigan St",
            "address_2": "6th Floor",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011033",
            "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.