Individual provider Active NPI

Chaya Kolodny, FNP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1134537772
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71016903A Issued in IN
Practice address
420 W 4TH St
Mishawaka, IN 46544-1948
Phone
(888) 580-1060
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 687958 NY
Family Nurse Practitioner 363LF0000X 71016903A IN Primary

Addresses

Primary practice location

420 W 4TH St
Mishawaka, IN 46544-1948

Mailing address

20 Old Turnpike Rd
Ste 307
Nanuet, NY 10954-2532
Phone (845) 624-0260

Other practice location 1

20 Old Turnpike Rd
ste 307
Nanuet, NY 10954-2532
Phone (845) 624-0260

Other identifiers 1

IdentifierTypeStateIssuer
687958OtherNYRN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813003343 IN Practitioner - Nurse Practitioner 4789182106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

420 W 4TH St
Mishawaka, IN 46544-1948
Phone 57430776734693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
687958NYMDRegistered Nurse
71016903AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc CurrentSince Jul 14, 2025 Accepting new patients
Healthlinc, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Healthlinc, Inc. Current Accepting new patients

Locations

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

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

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

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1134537772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OLD TURNPIKE RD",
            "address_2": "STE 307",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542532",
            "telephone_number": "845-624-0260",
            "fax_number": "845-624-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "888-580-1060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Old Turnpike Rd",
            "address_2": "ste 307",
            "address_purpose": "LOCATION",
            "city": "Nanuet",
            "state": "NY",
            "postal_code": "109542532",
            "country_code": "US",
            "telephone_number": "845-624-0260",
            "fax_number": "845-624-0264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLODNY",
        "first_name": "CHAYA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "687958",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016903A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "687958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.