Individual provider Active NPI

Kenneth Eugene Elek, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1912995267
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01031577A Issued in IN
Practice address
714 N Michigan St
South Bend, IN 46601-1035
Phone
(574) 647-7477
NPI assigned
Oct 11, 2005
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 01031577A IN Primary

Addresses

Primary practice location

714 N Michigan St
South Bend, IN 46601-1035

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ELEK@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
I20040930000123 IN Practitioner - Family Practice 7810966496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1982
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)

6913 N Main St
Medpoint Urgent Care
Granger, IN 46530-8039
Phone (574) 647-1550

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. Family Medicine CurrentSince Sep 17, 2010 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 17, 2010 Accepting new patients
Beacon Medical Group, Inc. Family Medicine Current Accepting new patients
Beacon Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (269) 552-2823

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

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

100 Navarre Pl
Ste 4470
South Bend, IN 46601
Phone (574) 647-1405

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

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

707 N Michigan St
Ste 102
South Bend, IN 46601
Phone (574) 367-3800

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: elek@mybeacon.cernerdirect.com
  • Direct secure messaging: kelek@mybeacon.cernerdirect.com
  • Direct secure messaging: kenelek@beacon.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1912995267",
    "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": "714 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011035",
            "telephone_number": "574-647-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEK",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01031577A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ELEK@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1815 E Ireland Rd",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466142845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.