Active NPI
Thomas Deverne Bussineau, D.O.
- Internal Medicine Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 02008147A
- Practice address
- 615 N Michigan St 1St FL Hospitalist Ste
South Bend, IN 46601-1033 - Phone
- (574) 647-3050
- Fax
- (574) 647-1094
- NPI assigned
- Jun 20, 2016
- Last updated
- Mar 30, 2026
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 02008147A | IN | Primary |
| Hospitalist Physician | 208M00000X | 02008147A | IN | |
| Hospitalist Physician | 208M00000X | 5101025254 | MI |
Addresses
Primary practice location
615 N Michigan St 1St FL Hospitalist Ste
South Bend, IN 46601-1033
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725
Other practice location 1
600 East Blvd 4th Floor Hospitalists Ste
Elkhart, IN 46514-2483
Phone (574) 389-7393
Other practice location 2
50505 Schoenherr Rd Ste 340
Shelby Township, MI 48315-3140
Phone (586) 731-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300100592 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
615 N Michigan St FL
1 Beacon Medical Group Hospital Spec
South Bend, IN 46601-1033
Phone (574) 647-3050
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Seasons Hospice & Palliative Care of Indiana, LLC | Family Medicine | Current | Accepting new patients |
| Great Lakes Medicine, PLC | Internal Medicine | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Seasons Medical Group of Indiana, PC | Current | Accepting new patients | |
| McLaren Macomb | Past | Accepting new patients |
Locations
1746 Momentum Pl
Chicago, IL 60689
600 East Blvd
Fl 4
Elkhart, IN 46514
Phone (574) 389-7393
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
6640 Intech Blvd
Ste 270
Indianapolis, IN 46278
Phone (317) 885-4200
615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100
50505 Schoenherr Rd
Ste 340
Shelby Township, MI 48315
Phone (586) 731-8400
Interoperability endpoints
- tbussineau282706@direct.hfhs.org
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.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
dba AccentCare Medical Group of Indiana
- Hospice and Palliative Medicine (Family Medicine) Physician
- Indianapolis, IN
- NPI 1861809451
-
- Hospitalist Physician
- Shelby Township, MI
- NPI 1740210517
Internal Medicine
-
dba Beacon Medical Group Anesthesia Elkhart
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
dba Beacon Bone and Joint Specialists
- Critical Care Medicine (Internal Medicine) Physician
- Elkhart, IN
- NPI 1821222829
Family Medicine
-
dba AccentCare Hospice & Palliative Care of Indiana
- Community Based Hospice Care Agency
- Indianapolis, IN
- NPI 1679746267
Family Medicine
-
- General Acute Care Hospital
- Mount Clemens, MI
- NPI 1316938327
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- 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": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1992155055",
"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": "615 N MICHIGAN ST 1ST FL HOSPITALIST STE",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011033",
"telephone_number": "574-647-3050",
"fax_number": "574-647-1094"
}
],
"practiceLocations": [
{
"address_1": "600 East Blvd 4th Floor Hospitalists Ste",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465142483",
"country_code": "US",
"telephone_number": "574-389-7393",
"fax_number": "574-647-1094",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "50505 Schoenherr Rd Ste 340",
"address_purpose": "LOCATION",
"city": "Shelby Township",
"state": "MI",
"postal_code": "483153140",
"country_code": "US",
"telephone_number": "586-731-8400",
"fax_number": "586-731-8406",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUSSINEAU",
"first_name": "THOMAS",
"middle_name": "DEVERNE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-20",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "02008147A",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IN",
"license": "02008147A",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MI",
"license": "5101025254",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300100592",
"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 Mar 30, 2026; 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.