Individual provider Active NPI

Abhishek Das, M.D.

  • Pain Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1932488665
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
01077117A Issued in IN
Practice address
5314 Lincolnway E
Mishawaka, IN 46544-4249
Phone
(574) 256-9032
Fax
(574) 256-9049
NPI assigned
Aug 11, 2011
Last updated
May 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 01077117A IN
Pain Medicine Physician 208VP0000X 01077117A IN Primary

Addresses

Primary practice location

5314 Lincolnway E
Mishawaka, IN 46544-4249

Mailing address

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

Other practice location 1

900 I St
LA Porte, IN 46350-5533
Phone (219) 324-1700

Other practice location 2

500 Arcade Ave Ste 200
Elkhart, IN 46514-2485
Phone (574) 294-8404

Other practice location 3

2222 Rieth Blvd Ste 104
Goshen, IN 46526-5869
Phone (574) 875-1082

Other practice location 4

100 Navarre Pl Ste 6600
South Bend, IN 46601-1173
Phone (574) 647-8800

Other identifiers 2

IdentifierTypeStateIssuer
565800023OtherINMEDICARE PTAN
201374760MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DAS@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801002733 IN Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 0840500039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 2011
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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 12, 2016 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Sep 12, 2016 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

500 Arcade Ave
Ste 200
Elkhart, IN 46514
Phone (574) 294-8404

2222 Rieth Blvd
Ste 104
Goshen, IN 46526
Phone (574) 875-1082

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

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

5314 Lincolnway E
Mishawaka, IN 46544
Phone (574) 256-9032

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

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

Interoperability endpoints

  • Direct secure messaging: das@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1932488665",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5314 LINCOLNWAY E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444249",
            "telephone_number": "574-256-9032",
            "fax_number": "574-256-9049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 I St",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1700",
            "fax_number": "219-324-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Arcade Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142485",
            "country_code": "US",
            "telephone_number": "574-294-8404",
            "fax_number": "574-523-1642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-1082",
            "fax_number": "574-875-3860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Navarre Pl Ste 6600",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011173",
            "country_code": "US",
            "telephone_number": "574-647-8800",
            "fax_number": "574-647-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAS",
        "first_name": "ABHISHEK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01077117A",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": "01077117A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "565800023",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201374760",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DAS@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "5314 Lincolnway E",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465444249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.