BETH ANN HAYDEN (FNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1003172719
Psychiatric/Mental Health Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for BETH ANN HAYDEN (FNP)
710 N NILES AVE
SOUTH BEND, IN 466171924
Phone: (574) 647-1610
Fax: (574) 237-6069
Type: Mailing
1001 Sturdy Rd
Valparaiso, IN 463834126
Phone: (219) 462-7504
Fax: (219) 462-7504
Type: Location
621 Memorial Dr
South Bend, IN 466011063
Phone: (574) 400-4550
Fax: (574) 400-4500
Type: Location
5314 Lincolnway E
Mishawaka, IN 465444249
Phone: (574) 256-9032
Fax: (574) 256-9049
Type: Location
900 I St
LA Porte, IN 463505533
Phone: (219) 324-1700
Fax: (219) 324-1602
Type: Location
1815 E Ireland Rd
South Bend, IN 466142845
Phone: (574) 647-1700
Fax: (574) 647-7572
Type: Location
707 N MICHIGAN ST
STE 400
SOUTH BEND, IN 466011067
Phone: (574) 647-8470
Fax: (574) 647-8475
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-03-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120606000535 | I | Nurse Practitioner | IN | TBD |
| I20210930000406 | I | Nurse Practitioner | KS | TBD |
| I20220321001098 | I | Nurse Practitioner | ME | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18 | 11 | $0 |
Insurance plans in this area (ZIP 46617)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | IN | 90792 | Psychiatric diagnostic evaluation with medical services | 23 | 23 |
Group practice members
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