Active NPI
Joseph Paul D'Haenens
- Emergency Medicine Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 01069274A
- Practice address
- 615 N Michigan St
South Bend, IN 46601-1033 - Phone
- (574) 647-7459
- Fax
- (574) 647-3658
- NPI assigned
- May 21, 2008
- Last updated
- Jul 29, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01069274A | IN | Primary |
Addresses
Primary practice location
615 N Michigan St
South Bend, IN 46601-1033
Mailing address
3355 Douglas Rd
Suite 300
South Bend, IN 46635-1781
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
- Emergency Medicine
- Education
- Indiana University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Bend Emergency Physicians, Inc | Emergency Medicine | Current | Accepting new patients |
| Emergency Physician Associates of North Carolina, P.C. | Emergency Medicine | Past | Accepting new patients |
Locations
1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967
3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788
615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- South Bend, IN
- NPI 1487132114
-
- Emergency Medicine Physician
- Jacksonville, NC
- NPI 1306887609
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bremen, IN
- NPI 1568417004
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
dba Memorial Epworth Center
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
dba Beacon Granger Hospital, A Memorial Hospital Extension
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469750400000",
"number": "1902063480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 DOUGLAS RD",
"address_2": "SUITE 300",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 N MICHIGAN ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011033",
"telephone_number": "574-647-7459",
"fax_number": "574-647-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'HAENENS",
"first_name": "JOSEPH",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2016-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01069274A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.