George Larsen Kneller, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01036729A Issued in IN

Practice address

900 I St
Laporte, IN 46350-5533

Phone

(219) 324-1700

Fax

(219) 324-1710

NPI assigned

Nov 2, 2005

Last updated

Oct 6, 2023By the provider in NPPES

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

Specialty

Family Practice

Education

Indiana University School of Medicine, 1985

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)

Hospital & facility affiliations

• Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kneller@mybeacon.cernerdirect.com
• Direct secure messaging: lkneller@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group NPD
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

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

  dba Beacon Medical Group E. Blair Warner

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1609828946
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Medical Group LaPorte

  • Family Medicine Physician
  • La Porte, IN
  • NPI 1639129117
  NPD

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

• Franciscan Health Michigan City

  dba Franciscan Health Michigan City at La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1679336747
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • Michigan City, IN
  • NPI 1710051941
  Care Compare affiliation

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1598756256",
    "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": "900 I ST",
            "city": "LAPORTE",
            "state": "IN",
            "postal_code": "463505533",
            "telephone_number": "219-324-1700",
            "fax_number": "219-324-1710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011035",
            "country_code": "US",
            "telephone_number": "574-647-7477",
            "fax_number": "574-647-3655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNELLER",
        "first_name": "GEORGE",
        "middle_name": "LARSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01036729A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100164530",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KNELLER@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 I St",
            "city": "Laporte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463505533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Delaney Rae Kirkendall, LSW
• Matthew Charles Kirkham, DC
• Ava Danielle Kirkland, OTR
• Ashley Katherine Kirkwood, M.D.
• Danielle Kmiec, MSW, LSW
• Michael L. Komasinski, O.D.
• Amanda B Kontor
• Marcia Kostka-Suvelza, O.D.
• Emma Krivak
• Michelle M Kroening, RPH

• Family Medicine Physician in La Porte, IN
• Providers in La Porte, 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 Oct 6, 2023; 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.