Kathryn Elaine Michalczyk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11015152A Issued in IN

Practice address

1811 Charlton CT
Goshen, IN 46526-6464

Phone

(574) 534-8200

Fax

(574) 534-0411

NPI assigned

Jun 30, 2009

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Female

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

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

Specialty

Family Practice

Education

University of Louisville School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Goshen Family PhysiciansGroup PAC ID 9739118308, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Goshen Family Physicians

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1033292735
  Medicare reassignment Care Compare group NPD

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

• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1528296373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 CHARLTON CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266464",
            "telephone_number": "574-534-8200",
            "fax_number": "574-534-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 CHARLTON CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266464",
            "telephone_number": "574-534-8200",
            "fax_number": "574-534-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALCZYK",
        "first_name": "KATHRYN",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11015152A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201023990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Max R. Mertz, M.D.
• Kristin Metzger
• Philip Metzler, MA
• Barbara Joan Meyer, MD
• Eleonora Meyta, NP
• Michiana Eye Center LLC
• Michiana Nurse-Midwives, LLC
• Michiana Physical Medicine PC
• Greg M Mielke, M.D.
• Matthew L Milanese, LCSW

• Family Medicine Physician in Goshen, IN
• Providers in Goshen, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.