Daniel Matthew Kinney, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01068216A Issued in IN

Practice address

1815 E Ireland Rd
South Bend, IN 46614-2845

Phone

(574) 647-1700

Fax

(574) 647-1708

NPI assigned

Aug 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kinney@mybeacon.cernerdirect.com

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 NPD
• Beacon Medical Group Inc

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1124079330
  NPD
• Beacon Medical Group, Inc.

  • Pediatrics Physician
  • South Bend, IN
  • NPI 1447203674
  NPD
• Beacon Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1831149525
  NPD (past)

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

{
    "created_epoch": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1518123124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-647-1700",
            "fax_number": "574-647-1708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-4540",
            "fax_number": "574-647-2567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "DANIEL",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-03",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01068216A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200985830",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KINNEY@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1815 E Ireland Rd",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466142845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olivia Mackenzie King, PA
• Robert Bruce King, MD
• Robert Preston King, M.D.
• Zaria King
• Reuben Kingamkono
• Delainey Kinney
• Devin Kinney, FNP
• Kimberly Kinney, PTA
• Leah C Kinney
• Cynthia Kinsey, RBT

• Pediatrics Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.