Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Memorial Hospital of South Bend

Organization Emergency Medicine Physician · NPI 1295772093

Memorial Hospital of South Bend is an Emergency Medicine Physician in South Bend, Indiana. Works from 2 locations. Medicare rates this hospital 2 out of 5. Licensed in Indiana.

CMS rating
2 of 5
Licensed in
IN
In the registry since
2006
Specialties on file
14
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CMS quality rating

2 out of 5 — official hospital rating from CMS Care Compare (CCN 150058)

Practice location Address checks out

615 N Michigan St
South Bend, IN 46601-1033
Phone: (574) 647-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 420 N Niles Ave, South Bend, IN 46617-1918 — (574) 647-8400

Specialties & licences

General Acute Care Hospital (primary) Taxonomy 282N00000X · Licence 06-005053 (IN)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 005053 (IN)
Hematology (Internal Medicine) Physician Taxonomy 207RH0000X
Medical Oncology Physician Taxonomy 207RX0202X
Gynecologic Oncology Physician Taxonomy 207VX0201X
Radiation Oncology Physician Taxonomy 2085R0001X
Occupational Therapist Taxonomy 225X00000X · Licence 005053 (IN)
Community Health Clinic/Center Taxonomy 261QC1500X · Licence 005053 (IN)
Psychiatric Hospital Unit Taxonomy 273R00000X
Rehabilitation Hospital Unit Taxonomy 273Y00000X · Licence 06-005053 (IN)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 005053 (IN)
Ambulance Taxonomy 341600000X
Air Ambulance Taxonomy 3416A0800X · Licence 005053 (IN)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1295772093
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Cfo · (574) 647-3460
NPI enumeratedJune 1, 2006
Last updated in NPPESJuly 14, 2026
Certification dateJuly 14, 2026
Mailing address615 N Michigan St, South Bend, IN 46601-1087

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