NPIMap

Individual provider Active NPI

Robert John Nydza, D.O.

  • Emergency Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1164782025
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5315054697 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 982-4941
NPI assigned
May 24, 2012
Last updated
May 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5315054697 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 982-4941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150123001675 MI Practitioner - Emergency Medicine 7517281470 Reassigns benefits to 2 organizations
I20180830003502 IN Practitioner - Emergency Medicine 7517281470 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epmg Southwest Michigan PLLCGroup PAC ID 2769719236, 45 clinicians
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians
South Bend Emergency Physicians IncGroup PAC ID 0941282354, 51 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (954) 939-5000

3500 Franciscan Way
Franciscan Health Michigan City
Michigan City, IN 46360-0021
Phone (219) 879-8511

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315054697MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Sep 30, 2023 Accepting new patients
Epmg Southwest Michigan PLLC Emergency Medicine CurrentSince Jul 5, 2019 Accepting new patients
Beacon Kalamazoo Inc CurrentSince Dec 1, 2014 Accepting new patients
South Bend Emergency Physicians, Inc Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Beacon Kalamazoo Inc CurrentSince Dec 1, 2014 Accepting new patients
Beacon Kalamazoo Inc Current Accepting new patients
Clarksville Physician Services PC CurrentSince Jan 3, 2024 Accepting new patients

Locations

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788

1010 W State Road 2
La Porte, IN 46350
Phone (219) 575-6640

3500 Franciscan Way
Michigan City, IN 46360
Phone (219) 852-1524

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

2000 Green Rd
Ste 300
Ann Arbor, MI 48105
Phone (313) 995-3764

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: rnydza431561@direct.franciscanalliance.org

Organizations & group practices 7

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 7

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1164782025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-982-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-982-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYDZA",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5315054697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.