NPIMap

Individual provider Active NPI

Benjamin P. Yourchock, MD

  • Family Medicine Physician
  • Walkerton, IN
National Provider Identifier
1730538414
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082203A Issued in IN
Practice address
506 Michigan Street
Walkerton, IN 46574-1116
Phone
(574) 335-5200
Fax
(574) 335-0858
NPI assigned
Jun 3, 2016
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01082203A IN Primary

Addresses

Primary practice location

506 Michigan Street
Walkerton, IN 46574-1116

Mailing address

707 Cedar St Ste 405
South Bend, IN 46617-2059

Other identifiers 2

IdentifierTypeStateIssuer
1102538181OtherINANTHEM
201376710MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722002446 IN Practitioner - Family Practice 3375836729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Toledo Medical College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Widener LN
Family Medicine at Miami Road
South Bend, IN 46614-3242
Phone (574) 335-7600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Medicine CurrentSince Jul 10, 2019 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. Family Medicine CurrentSince Jun 16, 2016 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jun 16, 2016 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 137
Mishawaka, IN 46545
Phone (574) 335-6214

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 407
Mishawaka, IN 46545
Phone (574) 335-6500

1025 Widener Ln
South Bend, IN 46614
Phone (574) 335-7600

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

707 Cedar St
Ste 405
South Bend, IN 46617
Phone (574) 237-7878

506 Michigan St
Walkerton, IN 46574
Phone (574) 586-3114

Interoperability endpoints

  • Direct secure messaging: byourchock85358@direct.trinity-health.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1730538414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MICHIGAN STREET",
            "city": "WALKERTON",
            "state": "IN",
            "postal_code": "465741116",
            "telephone_number": "574-335-5200",
            "fax_number": "574-335-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOURCHOCK",
        "first_name": "BENJAMIN",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082203A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102538181",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201376710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walkerton, IN

Sources for this page

Verify at the official NPI Registry.