Individual provider Active NPI

Donald R. Westerhausen Jr., M.D.

  • Cardiovascular Disease Physician
  • Lafayette, IN
National Provider Identifier
1871598235
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01041322A Issued in IN
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

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000000694301OtherINANTHEM
100327930MedicaidIN

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
I20041002000142 IN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9032000609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Minnesota Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

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

LicenseStateTypeSpecialty
01041322AINMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Aug 1, 2022 Accepting new patients
The South Bend Clinic, LLC CurrentSince Aug 1, 2022 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

  • Direct secure messaging: dwesterhausen252415@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: donald.westerhausen.1@7598.direct.athenahealth.com
  • FHIR API: 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.