Individual provider Active NPI

Daniel Francis Czarnecki, M.D.

  • Obstetrics & Gynecology Physician
  • South Bend, IN
National Provider Identifier
1124224373
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01069422 Issued in IN
Practice address
515 N Lafayette Blvd
South Bend, IN 46601-1003
Phone
(574) 232-2037
Fax
(574) 232-1420
NPI assigned
Jun 25, 2007
Last updated
Jul 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01069422 IN Primary

Addresses

Primary practice location

515 N Lafayette Blvd
South Bend, IN 46601-1003

Mailing address

6301 University Commons
Suite 230
South Bend, IN 46635-1571
Phone (574) 251-2100

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
I20110804000236 IN Practitioner - Obstetrics/Gynecology 7911176128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

14950 State Rd
Suite 23
Granger, IN 46530-7564
Phone (574) 234-8161

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000

6301 University Commons
South Bend, IN 46635-1416
Phone (574) 234-8161

6301 University Commons
Suite 360
South Bend, IN 46635-3500
Phone (574) 232-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069422INMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Jun 1, 2020 Accepting new patients
The South Bend Clinic, LLC CurrentSince Jun 1, 2020 Accepting new patients
Healthlinc, Inc. CurrentSince Jan 22, 2019 Accepting new patients
Healthlinc, Inc CurrentSince Jan 22, 2019 Accepting new patients

Locations

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

515 N Lafayette Blvd
South Bend, IN 46601
Phone (219) 232-2037

6301 University Commons
Ste 230
South Bend, IN 46635
Phone (574) 251-2115

6301 University Commons
Ste 360
South Bend, IN 46635
Phone (574) 232-4800

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

Interoperability endpoints

  • Direct secure messaging: dczarnecki253081@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1124224373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-251-2100",
            "fax_number": "574-251-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N LAFAYETTE BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011003",
            "telephone_number": "574-232-2037",
            "fax_number": "574-232-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "DANIEL",
        "middle_name": "FRANCIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01069422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.