Active NPI
Colin Talanda Fath, M.D.
- Surgical Critical Care Physician
- Elkhart, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- License
- 01091291A
- Practice address
- 500 Arcade Ave Ste 320
Elkhart, IN 46514-2477 - Phone
- (574) 523-7900
- Fax
- (574) 523-7909
- NPI assigned
- Jun 6, 2014
- Last updated
- Oct 10, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | R-10033 | IA | |
| Surgery Physician | 208600000X | 52660 | KY | |
| Surgery Physician | 208600000X | 01091291A | IN | |
| Surgical Critical Care Physician | 2086S0102X | 52660 | KY | |
| Surgical Critical Care Physician | 2086S0102X | 01091291A | IN | Primary |
| Trauma Surgery Physician | 2086S0127X | 4301505625 | MI |
Addresses
Primary practice location
500 Arcade Ave Ste 320
Elkhart, IN 46514-2477
Mailing address
3245 Health Dr Ste 100
South Bend, IN 46530-1380
Other practice location 1
University Of Kentucky General Surgery 800 Rose St
Lexington, KY 40536-1009
Phone (859) 323-5860
Other practice location 2
621 Memorial Dr
Suite 502
South Bend, IN 46601-1075
Phone (574) 647-5875
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300055631 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Wayne State University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 Arcade Ave
Suite 320
Elkhart, IN 46514-2477
Phone (574) 523-7900
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-10033 | IA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Promed Healthcare | Current | Accepting new patients | |
| Beacon Medical Group Michigan Inc | Surgery | Current | Accepting new patients |
| Beacon Medical Group Michigan Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Surgery | Current | Accepting new patients |
Locations
500 Arcade Ave
Ste 320
Elkhart, IN 46514
Phone (574) 293-3317
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
621 Memorial Dr
Ste 502
South Bend, IN 46601
Phone (574) 234-9001
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
1717 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5050
1717 Shaffer St
Ste 002
Kalamazoo, MI 49048
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
Interoperability endpoints
- cfath22679@ukhcdirect.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.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
dba Beacon Medical Group Michigan
- Family Medicine Physician
- Portage, MI
- NPI 1497709869
Surgery
-
dba Beacon Medical Group Anesthesia Elkhart
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
dba Beacon Bone and Joint Specialists
- Critical Care Medicine (Internal Medicine) Physician
- Elkhart, IN
- NPI 1821222829
Surgery
-
dba Beacon Medical Group Michigan
- Internal Medicine Physician
- Kalamazoo, MI
- NPI 1720009954
-
dba Borgess Women's Health
- Rural Health Clinic/Center
- Plainwell, MI
- NPI 1487708830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1811300817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 HEALTH DR STE 100",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "465301380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ARCADE AVE STE 320",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142477",
"telephone_number": "574-523-7900",
"fax_number": "574-523-7909"
}
],
"practiceLocations": [
{
"address_1": "University Of Kentucky General Surgery 800 Rose St",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405361009",
"country_code": "US",
"telephone_number": "859-323-5860",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "621 Memorial Dr",
"address_2": "Suite 502",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011075",
"country_code": "US",
"telephone_number": "574-647-5875",
"fax_number": "574-647-5878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FATH",
"first_name": "COLIN",
"middle_name": "TALANDA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-06",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "R-10033",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "52660",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01091291A",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "KY",
"license": "52660",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "IN",
"license": "01091291A",
"primary": true
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "MI",
"license": "4301505625",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300055631",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.