Michiana Physical Medicine

Primary specialty

SpecialistTaxonomy code 174400000X

License

01041839A Issued in IN

Legal business name

MICHIANA PHYSICAL MEDICINE

Practice address

1510 Osolo Rd
Elkhart, IN 46514-4122

Phone

(574) 534-4648

NPI assigned

Jun 4, 2007

Last updated

Aug 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joan L Szynal, M.D.

Title

Owner

Phone

(574) 264-7085

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Michiana Physical Medicine

  • Specialist
  • Elkhart, IN
  • NPI 1164624649

  O20060106000024

  Same enrollment
• Michiana Physical Medicine PC

  • Physical Therapist
  • Goshen, IN
  • NPI 1336175769

  O20060106000024

  Same enrollment

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1144422924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 WINSTED DR",
            "address_2": "SUITE 3",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264696",
            "telephone_number": "574-266-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 OSOLO RD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465144122",
            "telephone_number": "574-534-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIANA PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "SZYNAL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-264-7085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01041839A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200022590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Hartman PC (Michael J. Hartman, MD, P.C.)
• Michelle Thomas, LCSW, LLC (Mindwell Counseling Group)
• Michiana Counseling Group, LLC
• Michiana Eye Center , LLC
• Michiana Internal Medicine PC
• Michiana Physical Medicine
• Estrella Miguel
• Mariana Millan Montiel
• Abigale Miller
• Allison K Miller, MS, OTR/L

• Specialist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.