Individual provider Active NPI

Gurudutt B. Kulkarni, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Elkhart, IN
National Provider Identifier
1326042102
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
01059636A Issued in IN
Practice address
500 Arcade Ave
Ste 400
Elkhart, IN 46514-2477
Phone
(574) 522-2284
Fax
(574) 522-3952
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01059636A IN
Clinical Cardiac Electrophysiology Physician 207RC0001X 01059636A IN Primary
Internal Medicine Physician 207R00000X 01059636A IN

Addresses

Primary practice location

500 Arcade Ave
Ste 400
Elkhart, IN 46514-2477

Mailing address

3245 Health Drive
Suite 100
Granger, IN 46530-3245
Phone (574) 647-1840

Other identifiers 1

IdentifierTypeStateIssuer
200401780MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KULKARNI@mybeacon.cernerdirect.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000147 IN Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 2062472293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

500 Arcade Ave
Suite 400
Elkhart, IN 46514-2487
Phone (574) 522-2284

600 E Blvd
Elkhart, IN 46514-2483

600 E Blvd 4TH FL Hospitalists
BMG Hospital Specialties
Elkhart, IN 46514-2483
Phone (574) 647-3050

6913 N Main St
Granger, IN 46530-8039

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059636AINMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Cardiovascular Disease CurrentSince Jan 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Cardiovascular Disease Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

500 Arcade Ave
Ste 400
Elkhart, IN 46514
Phone (574) 522-2284

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

621 Memorial Dr
Ste 502
South Bend, IN 46601
Phone (574) 234-9001

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Interoperability endpoints

  • Direct secure messaging: gkulkarni@mybeacon.cernerdirect.com
  • Direct secure messaging: kulkarni@mybeacon.cernerdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1326042102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DRIVE",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465303245",
            "telephone_number": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE",
            "address_2": "STE 400",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142477",
            "telephone_number": "574-522-2284",
            "fax_number": "574-522-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULKARNI",
        "first_name": "GURUDUTT",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01059636A",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IN",
            "license": "01059636A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059636A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200401780",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KULKARNI@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "500 Arcade Ave",
            "address_2": "Ste 400",
            "city": "Elkhart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465142477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.