Individual provider Active NPI

Iryna Kulyk, MD

  • Rheumatology Physician
  • Granger, IN
National Provider Identifier
1487062741
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
01080914A Issued in IN
Practice address
3220 Beacon Pkwy
Granger, IN 46530-7196
Phone
(574) 999-8788
Fax
(574) 999-8781
NPI assigned
Jul 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01080914A IN
Rheumatology Physician 207RR0500X 01080914A IN Primary
Internal Medicine Physician 207R00000X 290275 NY
Internal Medicine Physician 207R00000X 125.064370 IL

Addresses

Primary practice location

3220 Beacon Pkwy
Granger, IN 46530-7196

Mailing address

3245 Health Dr
Granger, IN 46530-1380
Phone (574) 647-3725

Other practice location 1

615 N Michigan St Fl 1
South Bend, IN 46601-1033
Phone (574) 647-3050 ext. 70625

Other identifiers 1

IdentifierTypeStateIssuer
300019673MedicaidIN

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
I20180816002257 IN Practitioner - Internal Medicine 0941524078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital of South BendGroup PAC ID 8123017126, 3 clinicians

Practice addresses (Care Compare)

3220 Beacon Pkwy
Granger, IN 46530-7196
Phone (574) 999-8788

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290275NYMDLicensed Practical Nurse
125.064370ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of South Bend CurrentSince Jan 12, 2026 Accepting new patients
Memorial Hospital of South Bend CurrentSince Jan 12, 2026 Accepting new patients
Memorial Hospital of South Bend Past Accepting new patients

Locations

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

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

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

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

Organizations & group practices 3

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": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1487062741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR",
            "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": "3220 BEACON PKWY",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307196",
            "telephone_number": "574-999-8788",
            "fax_number": "574-999-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 N Michigan St Fl 1",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011033",
            "country_code": "US",
            "telephone_number": "574-647-3050 x70625",
            "fax_number": "574-647-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULYK",
        "first_name": "IRYNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01080914A",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IN",
            "license": "01080914A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "290275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.064370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300019673",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.