Active NPI
James Alan Handtke, DO
- Family Medicine Physician
- Middlebury, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02007362A
- Practice address
- 206 W Warren St
Middlebury, IN 46540-9410 - Phone
- (574) 825-2146
- NPI assigned
- Apr 5, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 02007362A | IN | Primary |
Addresses
Primary practice location
206 W Warren St
Middlebury, IN 46540-9410
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (547) 647-1840
Other practice location 1
714 N Michigan St
South Bend, IN 46601-1035
Phone (575) 647-7477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300039079 | Medicaid | IN |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
206 W Warren St
Beacon Medical Group Middlebury
Middlebury, IN 46540-9410
Phone (574) 825-2146
Hospital & facility affiliations
- Elara Caring
- Elkhart General Hospital
- Goshen Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02007362A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
206 W Warren St
Middlebury, IN 46540
Phone (219) 825-2146
714 N Michigan St
South Bend, IN 46601
Phone (574) 647-7477
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Family Medicine Physician
- Middlebury, IN
- NPI 1114363835
-
- Family Medicine Physician
- South Bend, IN
- NPI 1609828946
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- Home Health Agency
- Valparaiso, IN
- NPI 1013493493
-
- General Acute Care Hospital
- Goshen, IN
- NPI 1740268846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1033748710",
"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": "547-647-1840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 W WARREN ST",
"city": "MIDDLEBURY",
"state": "IN",
"postal_code": "465409410",
"telephone_number": "574-825-2146"
}
],
"practiceLocations": [
{
"address_1": "714 N Michigan St",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011035",
"country_code": "US",
"telephone_number": "575-647-7477",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HANDTKE",
"first_name": "JAMES",
"middle_name": "ALAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-05",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "02007362A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300039079",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Middlebury, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.