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

Benjamin Haberly

Individual provider Surgical Physician Assistant · NPI 1679176200

Benjamin Haberly is a Physician Assistant in South Bend, Indiana. Qualified in 2020, 6 years ago. Practices with Rci (Wrs) LLC, a 330-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
6
Licensed in
IN
In the registry since
2020
Specialties on file
2

Practice location Address checks out

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone: (574) 247-9441
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 303 S Nappanee St Ste F, Elkhart, IN 46514-2066 — (574) 247-9441
  • 60160 Bodnar Blvd, Mishawaka, IN 46544-9338 — (574) 247-9441
  • 2349 Lake Ave Ste 201, Plymouth, IN 46563-7837 — (574) 247-9441

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 10003022A (IN)
Physician Assistant Taxonomy 363A00000X · Licence 10003022A (IN)

Record details

NPI number1679176200
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 17, 2020
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Rci (Wrs) Llc — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in South Bend