Individual provider Active NPI

Garrett Muhlstadt, DO

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1609496686
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101027157 Issued in MI
Practice address
615 N Michigan St FL 1
South Bend, IN 46601-1033
Phone
(574) 647-3050
Fax
(574) 647-1094
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101027157 MI Primary
Family Medicine Physician 207Q00000X 02007317A IN

Addresses

Primary practice location

615 N Michigan St FL 1
South Bend, IN 46601-1033

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

2002 S 11th St
Niles, MI 49120-4074
Phone (269) 687-0200

Other practice location 2

714 N Michigan St
South Bend, IN 46601-1035
Phone (574) 647-7477

Other identifiers 1

IdentifierTypeStateIssuer
300039759MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230707003366 MI Practitioner - Family Practice 7517389877 Reassigns benefits to 2 organizations
I20230905001549 IN Practitioner - Family Practice 7517389877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Community Hospital WatervlietGroup PAC ID 7416942750, shared by 7 NPIs, 66 clinicians
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

42 N Saint Joseph Ave
Suite 300
Niles, MI 49120-2203
Phone (269) 687-2910

615 N Michigan St FL
1 BMG Hospital Specialties
South Bend, IN 46601-1033
Phone (574) 647-3050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02007317AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Jan 19, 2026 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jun 15, 2023 Accepting new patients
Beacon Medical Group, Inc. Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jun 15, 2023 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Lakeland Medical Practices CurrentSince Jan 19, 2026 Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

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

714 N Michigan St
South Bend, IN 46601
Phone (574) 647-7477

133 W Main St
Benton Harbor, MI 49022
Phone (269) 408-2258

42 N Saint Joseph Ave
Ste 300
Niles, MI 49120
Phone (269) 687-2910

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: gmuhlstadt1462781@epic00.corewelldirect.org

Organizations & group practices 7

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 6

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1609496686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST FL 1",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-3050",
            "fax_number": "574-647-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491204074",
            "country_code": "US",
            "telephone_number": "269-687-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "MUHLSTADT",
        "first_name": "GARRETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027157",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02007317A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300039759",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.