Active NPI
Donald R. Westerhausen Jr., M.D.
- Cardiovascular Disease Physician
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 01041322A
- Practice address
- 3900 St Francis Way Ste 205
Lafayette, IN 47905-4939 - Phone
- (765) 428-2500
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 01041322A | IN | |
| Cardiovascular Disease Physician | 207RC0000X | 01041322A | IN | Primary |
Addresses
Primary practice location
3900 St Francis Way Ste 205
Lafayette, IN 47905-4939
Mailing address
3900 St Francis Way Ste 205
Lafayette, IN 47905-4939
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000694301 | Other | IN | ANTHEM |
| 100327930 | Medicaid | IN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- University of Minnesota Medical School, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01041322A | IN | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The South Bend Clinic LLC | Current | Accepting new patients | |
| The South Bend Clinic, LLC | Current | Accepting new patients | |
| Memorial Hospital of South Bend | Past | Accepting new patients |
Locations
500 Arcade Ave
Ste 400
Elkhart, IN 46514
Phone (574) 522-2284
301 E Day Rd
Mishawaka, IN 46545
Phone (574) 204-7300
611 E Douglas Rd
Ste 208
Mishawaka, IN 46545
Phone (574) 232-5928
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000
Interoperability endpoints
- dwesterhausen252415@dulyhealthandcare.direct-ci.com
- donald.westerhausen.1@7598.direct.athenahealth.com
- https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
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.
-
- Clinic/Center
- South Bend, IN
- NPI 1073680419
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1487307492
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1023965795
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1871598235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 ST FRANCIS WAY STE 205",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 ST FRANCIS WAY STE 205",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054939",
"telephone_number": "765-428-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTERHAUSEN",
"first_name": "DONALD",
"middle_name": "R.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IN",
"license": "01041322A",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IN",
"license": "01041322A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000694301",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100327930",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.