Individual provider Active NPI

Susana Diaz, CNM

  • Advanced Practice Midwife
  • South Bend, IN
National Provider Identifier
1972857704
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
09000225A Issued in IN
Practice address
621 Memorial Dr Ste 403
South Bend, IN 46601-1074
Phone
(574) 647-1405
Fax
(574) 647-3970
NPI assigned
Oct 31, 2012
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 09000225A IN Primary

Addresses

Primary practice location

621 Memorial Dr Ste 403
South Bend, IN 46601-1074

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725

Other practice location 1

6913 N Main St Ste 300
Granger, IN 46530-8039
Phone (574) 647-1500

Other practice location 2

202 Lincolnway E Ste 201
Mishawaka, IN 46544-2079
Phone (574) 584-2812

Other identifiers 3

IdentifierTypeStateIssuer
178420006OtherINMEDICARE PTAN
201132350MedicaidIN
236040262OtherINMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DIAZ@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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130426000559 IN Practitioner - Certified Nurse Midwife (CNM) 7315183993 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
09000225AINMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Healthlinc, Inc. CurrentSince Mar 8, 2020 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 1, 2018 Accepting new patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince Mar 8, 2020 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

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

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

6913 N Main St
Ste 300
Granger, IN 46530
Phone (574) 647-1500

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

710 Franklin St
Ste 200
Michigan City, IN 46360
Phone (219) 872-6200

202 Lincolnway E
Ste 201
Mishawaka, IN 46544
Phone (574) 584-2812

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

100 Navarre Pl
Ste 4470
South Bend, IN 46601
Phone (574) 647-1300

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

360 N Notre Dame Ave
#C
South Bend, IN 46617
Phone (574) 245-4979

621 Memorial Dr
Ste 403
South Bend, IN 46601
Phone (574) 647-1405

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

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

Interoperability endpoints

  • Direct secure messaging: diaz@mybeacon.cernerdirect.com
  • Direct secure messaging: susanadiaz@beacon.allscriptsdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1972857704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 403",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011074",
            "telephone_number": "574-647-1405",
            "fax_number": "574-647-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Lincolnway E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465442079",
            "country_code": "US",
            "telephone_number": "574-584-2812",
            "fax_number": "574-584-2813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "SUSANA",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000225A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "178420006",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201132350",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "236040262",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DIAZ@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "6913 N Main St Ste 300",
            "city": "Granger",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465308039",
            "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.