Kirk Jon Bodach, MD

Key facts

NPI

1306044003

Entity type

Individual (NPI type 1)

Primary specialty

Hospitalist Physician 208M00000X

License

01065817A (IN)

Practice address

615 N Michigan St FL 1
South Bend, IN 46601-1033

Phone

(574) 647-3050

Fax

(574) 647-1094

NPI assigned

Jul 5, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Beacon Medical Group, Inc. Family Medicine Physician · Mishawaka, IN · NPI 1033161617
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · IN
• Beacon Medical Group Inc Anesthesiology Physician · Elkhart, IN · NPI 1437803285
  NPD
• Beacon Medical Group, Inc. Physical Therapist · Granger, IN · NPI 1053864868
  NPD
• Beacon Medical Group, Inc. Family Medicine Physician · South Bend, IN · NPI 1124079330
  NPD FAMILY MEDICINE
• Beacon Medical Group, Inc. Critical Care Medicine (Internal Medicine) Physician · Elkhart, IN · NPI 1821222829
  NPD (past) FAMILY MEDICINE

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elkhart General Hospital, Inc. General Acute Care Hospital · Elkhart, IN · NPI 1477551489
  Care Compare affiliation Hospital
• Memorial Hospital of South Bend General Acute Care Hospital · South Bend, IN · NPI 1295772093
  Care Compare affiliation Hospital
• Memorial Hospital of South Bend Psychiatric Hospital Unit · South Bend, IN · NPI 1376841395
  Care Compare affiliation Hospital
• Memorial Hospital of South Bend General Acute Care Hospital · Granger, IN · NPI 1881177756
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

Indiana University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group Inc (575 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital · South Bend, IN · CCN 150058
• Elkhart General Hospital Hospital · Elkhart, IN · CCN 150018

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

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 30, 2026.

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1306044003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST FL 1",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-3050",
            "fax_number": "574-647-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 East Blvd 4th Floor Hospitalists Ste",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142483",
            "country_code": "US",
            "telephone_number": "574-389-7393",
            "fax_number": "574-647-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODACH",
        "first_name": "KIRK",
        "middle_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01065817A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01065817A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M400050759",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01050896",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200986910",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEMORIAL HOSPITALIST GROUP",
            "identifier": "000000720320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbodach@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "615 N Michigan St Fl 1",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in South Bend, IN · Hospitalist Physician in Indiana