Active NPI
Maria Elisabeth Faase, M.D.
- Neonatal-Perinatal Medicine Physician
- Mishawaka, IN
National Provider Identifier
1851486930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 01072165
- Practice address
- 5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469 - Phone
- (574) 335-4145
- Fax
- (574) 335-4146
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 038145 | GA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 01072165 | IN | Primary |
Addresses
Primary practice location
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Mailing address
707 Cedar St Ste 405
South Bend, IN 46617-2059
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00685913H | Medicaid | GA | |
| 038145 | Other | GA | GA LICENSE NUMBER |
| 201222680 | Medicaid | IN | |
| 000000925186 | Other | IN | BCBS NICU |
| 000000859438 | Other | IN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038145 | GA | MD | Neonatal-Perinatal Medicine Physician |
| 01072165 | IN | MD | Neonatal-Perinatal Medicine Physician |
Interoperability endpoints
- mfaase1147673@direct.trinity-health.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1851486930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 CEDAR ST STE 405",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5215 HOLY CROSS PKWY",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451469",
"telephone_number": "574-335-4145",
"fax_number": "574-335-4146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAASE",
"first_name": "MARIA",
"middle_name": "ELISABETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2023-07-06",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "GA",
"license": "038145",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IN",
"license": "01072165",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00685913H",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA LICENSE NUMBER",
"identifier": "038145",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201222680",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NICU",
"identifier": "000000925186",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000859438",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.