Individual provider Active NPI

Heidi Schelstraete, NP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1912359662
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006373A Issued in IN
Practice address
100 Navarre PL Ste 6600
South Bend, IN 46601-1173
Phone
(574) 647-8800
Fax
(574) 647-8811
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71006373A IN
Family Nurse Practitioner 363LF0000X 71006373A IN Primary

Addresses

Primary practice location

100 Navarre PL Ste 6600
South Bend, IN 46601-1173

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other practice location 1

611 Douglas Rd Ste 207
Mishawaka, IN 46545-1465
Phone (574) 647-8800

Other practice location 2

900 I St
LA Porte, IN 46350-5533
Phone (219) 324-1730

Other identifiers 2

IdentifierTypeStateIssuer
201003280CMedicaidIN
201375460MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hschelstraete@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160802001757 IN Practitioner - Nurse Practitioner 2668766486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

100 Navarre PL
6600 BMG N Central Neurosurgery SB
South Bend, IN 46601-1173
Phone (574) 647-8800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006373AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Family CurrentSince Feb 3, 2019 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Feb 3, 2019 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

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

900 I St
Laporte, IN 46350
Phone (219) 324-1670

611 E Douglas Rd
Ste 207
Mishawaka, IN 46545
Phone (574) 335-6450

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

100 Navarre Pl
Ste 6600
South Bend, IN 46601
Phone (574) 232-7227

Interoperability endpoints

  • Direct secure messaging: hschelstraete@mybeacon.cernerdirect.com

Organizations & group practices 4

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 10

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1912359662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 6600",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011173",
            "telephone_number": "574-647-8800",
            "fax_number": "574-647-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Douglas Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465451465",
            "country_code": "US",
            "telephone_number": "574-647-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I St",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHELSTRAETE",
        "first_name": "HEIDI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006373A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006373A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201003280C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201375460",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hschelstraete@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl Ste 6600",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011173",
            "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.