NPIMap

Individual provider Active NPI

Chinyama Munakampe, MD

  • Family Medicine Physician
  • Granger, IN
National Provider Identifier
1770146185
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01088180A Issued in IN
Practice address
6913 N Main St Ste 300
Granger, IN 46530-8039
Phone
(574) 647-1500
Fax
(574) 647-2567
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 01088180A IN Primary

Addresses

Primary practice location

6913 N Main St Ste 300
Granger, IN 46530-8039

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2129

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
300027266MedicaidIN

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
I20220816001606 IN Practitioner - Family Practice 0840524492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
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)

714 N Michigan St
Beacon Medical Group E Blair Warner
South Bend, IN 46601-1035
Phone (574) 647-7477

Hospital & facility affiliations

  • Elara Caring Home health agency, Kokomo, IN, CCN 157586
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 29, 2022 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group, Inc. Family Medicine CurrentSince Aug 29, 2022 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Ste 300
Granger, IN 46530
Phone (574) 647-1500

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

Organizations & group practices 5

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 7

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1770146185",
    "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",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 N MAIN ST STE 300",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308039",
            "telephone_number": "574-647-1500",
            "fax_number": "574-647-2567"
        }
    ],
    "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": "MUNAKAMPE",
        "first_name": "CHINYAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01088180A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300027266",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.