Kathryn Bachman, DO
Individual provider Active NPI Family Medicine Physician · Goshen, IN
NPI 1124430459 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1124430459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02004724A (IN)
- Practice address
- 2120 Rieth Blvd Ste a
Goshen, IN 46526-5858 - Phone
- (574) 875-5126
- NPI assigned
- May 21, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beacon Medical Group Inc
Practice addresses (Care Compare)
2120 Rieth Blvd
Suite a
Goshen, IN 46526-5858
Phone (574) 875-5126
Hospital & facility affiliations
- Elkhart General Hospital
- Goshen Hospital
- Memorial Hospital of South Bend
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211108001705 | IN | Practitioner - Family Practice | 1052532678 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02004724A | IN | MD | General Practice Physician |
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 | |
| Mid-Valley Healthcare, 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
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
Interoperability endpoints
- kbachman122944@ecommunitydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO181076 | OR | |
| General Practice Physician | 208D00000X | 02004724A | IN | |
| Family Medicine Physician | 207Q00000X | 02004724A | IN | Yes |
Addresses
Primary practice location
2120 Rieth Blvd Ste a
Goshen, IN 46526-5858
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 236040380 | Other | IN | MEDICARE PTAN |
| 201231260 | Medicaid | IN |
Other names
- Kathryn Schlabach
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kbachman134252@samhealth.direct-ci.com |
Other providers in Goshen, IN
- Anastasia Attali
- Stephanie Augustine
- Australia Anesthesia Management LLC
- Avad Chiropractic & Wellness LLC
- Melissa L Bach
- Brittany Bahr
- Brenda Balcazar Gorostiet
- Gabrielle Balser
- Maya Bar-Zvi
- Elisabeth A Barahona
All providers in Goshen, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.