Individual provider Active NPI

Janel L. Charlton, MD

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1770711145
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01070363A Issued in IN
Practice address
714 N Michigan St
South Bend, IN 46601-1035
Phone
(574) 647-7477
Fax
(574) 647-3655
NPI assigned
Jun 24, 2009
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 01070363A IN Primary

Addresses

Primary practice location

714 N Michigan St
South Bend, IN 46601-1035

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other identifiers 2

IdentifierTypeStateIssuer
201073620MedicaidIN
000000776952OtherINBCBS BMG E BLAIR WARNER

Other names 1

  • Janel L. Daufenbach Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHARLTON@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120709000021 IN Practitioner - Family Practice 8921263401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2009
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070363AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group, Inc. Family Medicine CurrentSince Jun 3, 2014 Accepting new patients
Beacon Medical Group Inc CurrentSince Jun 3, 2014 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

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

900 I St
Laporte, IN 46350
Phone (219) 324-1670

100 Navarre Pl
Ste 4470
South Bend, IN 46601
Phone (574) 647-1300

111 W Jefferson Blvd
Ste 100
South Bend, IN 46601
Phone (574) 647-1669

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

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

Interoperability endpoints

  • Direct secure messaging: charlton@mybeacon.cernerdirect.com
  • Direct secure messaging: janelcharlton@beaconfp.allscriptsdirect.net
  • Direct secure messaging: jcharlton@mybeacon.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1770711145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011035",
            "telephone_number": "574-647-7477",
            "fax_number": "574-647-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "JANEL",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01070363A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201073620",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG E BLAIR WARNER",
            "identifier": "000000776952",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHARLTON@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "714 N Michigan St",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANEL",
            "last_name": "DAUFENBACH",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.