Ellen Cunningham, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01089272A Issued in IN

Practice address

1802 Day Rd
Mishawaka, IN 46545-4329

Phone

(574) 204-7200

Fax

(574) 252-0633

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, IN2 enrollments

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 2

Specialty

Dermatology

Education

Other, 1995

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecunningham255895@dulyhealthandcare.direct-ci.com
• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD
• Clark Dermatology, LLC

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1417316274
  NPD (past)
• Marieanne Giardina-Beckett MD

  • Dermatology Physician
  • Secaucus, NJ
  • NPI 1215144811
  NPD (past)
• Schweiger Dermatology, PC

  • Dermatology Physician
  • Elmer, NJ
  • NPI 1104229392
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1205902186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091043",
            "telephone_number": "973-785-8686",
            "fax_number": "973-785-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465454329",
            "telephone_number": "574-204-7200",
            "fax_number": "574-252-0633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2102 E Inwood Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142443",
            "country_code": "US",
            "telephone_number": "574-204-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01089272A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Crum, PTA
• Margot Matzallany Cruz-Portillo
• Reyna Cruz
• Jennifer Lynn Cummings, CP
• Alexis Ann Cunningham-Gloster
• Terry L Cunningham, DDS
• Katherine Curley
• Daniel Curnyn, MD
• Ian M Curtis, LCSW
• Jeannine M Curtis, LCSW

• Dermatology Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.