Active NPI
Robert Alan Fiedler, NP
- Family Nurse Practitioner
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71011292A
- Practice address
- 211 N Eddy St
South Bend, IN 46617-3096 - Phone
- (574) 234-4100
- NPI assigned
- Jul 13, 2021
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71011292A | IN | Primary |
Addresses
Primary practice location
211 N Eddy St
South Bend, IN 46617-3096
Mailing address
211 N Eddy St
South Bend, IN 46617-3096
Phone (742) 344-1005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300052705 | 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- 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
52500 Fir Rd
Granger, IN 46530-8579
Phone (574) 271-0700
Hospital & facility affiliations
- Memorial Hospital of South Bend
- Woodlawn Hospital
- Saint Joseph Regional Medical Center - Plymouth
- Community Hospital of Bremen Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71011292A | IN | MD | Family Nurse Practitioner |
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 | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients |
Locations
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
610 N Michigan St
Ste 306
South Bend, IN 46601
Phone (574) 647-6500
621 Memorial Dr
Ste 502
South Bend, IN 46601
Phone (574) 234-9001
Interoperability endpoints
- rfiedler261112@dulyhealthandcare.direct-ci.com
- https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
Organizations & group practices 5
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
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Trauma Surgery Physician
- South Bend, IN
- NPI 1174927131
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1487307492
Hospital & facility affiliations 6
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
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
- General Acute Care Hospital
- Plymouth, IN
- NPI 1174571129
-
- Critical Access Hospital
- Rochester, IN
- NPI 1265413405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1962074583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 N EDDY ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466173096",
"telephone_number": "742-344-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 N EDDY ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466173096",
"telephone_number": "574-234-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIEDLER",
"first_name": "ROBERT",
"middle_name": "ALAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-13",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71011292A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300052705",
"state": "IN"
}
],
"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 Jun 30, 2025; 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.