Individual provider Active NPI

James Alan Handtke, DO

  • Family Medicine Physician
  • Middlebury, IN
National Provider Identifier
1033748710
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02007362A Issued in IN
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

Updated by the provider on Aug 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
300039079MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731002912 IN Practitioner - Family Practice 3072935386 Reassigns benefits to 1 organization

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
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

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 Home health agency, Valparaiso, IN, CCN 157095
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02007362AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group, Inc. Family Medicine CurrentSince Aug 14, 2023 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 14, 2023 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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.