Individual provider Active NPI

Kyleigh Girardi

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1780249946
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1815 E Ireland Rd
South Bend, IN 46614-2845
Phone
(574) 647-5790
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1815 E Ireland Rd
South Bend, IN 46614-2845

Mailing address

1522 Jody CT
South Bend, IN 46628-3875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118001917 IN Practitioner - Physical Therapist in Private Practice 9931570538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Health LLCGroup PAC ID 1254690530, 32 clinicians

Practice addresses (Care Compare)

1815 E Ireland Rd
Suite 100
South Bend, IN 46614-2845
Phone (574) 647-5790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health, LLC Physical Therapist CurrentSince Dec 19, 2022 Accepting new patients
Beacon Medical Group, Inc. PastSince Dec 19, 2022 Accepting new patients
Beacon Health, LLC Past Accepting new patients

Locations

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

1815 E Ireland Rd
#100
South Bend, IN 46614
Phone (574) 647-5790

1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1780249946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 JODY CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-647-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARDI",
        "first_name": "KYLEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.