Active NPI
Laura E Munkel, M.D.
- Family Medicine Physician
- Goshen, IN
National Provider Identifier
1104825223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01055084A
- Practice address
- 2120 Rieth Blvd
Suite a
Goshen, IN 46526-5843 - Phone
- (574) 875-5126
- Fax
- (574) 875-1874
- NPI assigned
- Jul 20, 2005
- Last updated
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01055084A | IN | Primary |
Addresses
Primary practice location
2120 Rieth Blvd
Suite a
Goshen, IN 46526-5843
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000200984 | Other | IN | ANTHEM BCBS |
| P01316631 | Other | IN | RR MEDICARE |
| 200348260 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUNKEL@mybeacon.cernerdirect.com |
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
- Rush Medical College of Rush University, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2120 Rieth Blvd
Suite a
Goshen, IN 46526-5858
Phone (574) 875-5126
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
Interoperability endpoints
- munkel@mybeacon.cernerdirect.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
dba Beacon Medical Group Anesthesia Elkhart
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
dba Med Point Urgent Care Center at CR 6
- Family Medicine Physician
- Elkhart, IN
- NPI 1710329008
-
- 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
-
- 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": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1104825223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N NILES AVE",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466171924",
"telephone_number": "574-647-1610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 RIETH BLVD",
"address_2": "SUITE A",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465265843",
"telephone_number": "574-875-5126",
"fax_number": "574-875-1874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNKEL",
"first_name": "LAURA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01055084A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000200984",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01316631",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200348260",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUNKEL@mybeacon.cernerdirect.com",
"affiliation": "N",
"address_1": "2120 Rieth Blvd",
"address_2": "Suite A",
"city": "Goshen",
"state": "IN",
"country_code": "US",
"postal_code": "465265843",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.