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DR. CHRISTIAAN NIKOLAJE MAMCZAK DO NPI 1912112384


NPI Information

NPI: 1912112384
Provider Name: DR. CHRISTIAAN NIKOLAJE MAMCZAK, DO
Classification: Orthopaedic Surgery - 207XX0801X
Entity Type: Individual

Specialization: Orthopaedic Trauma

Organization: BEACON MEDICAL GROUP INC

PECOS Registration: Yes

Address:
100 NAVARRE PL STE 4440
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-5300
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DR. Christiaan Nikolaje Mamczak, DO is an orthopaedic trauma orthopaedic surgery in South Bend, IN with 21 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. DR. Christiaan Nikolaje Mamczak, DO NPI is 1912112384. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 NAVARRE PL STE 4440
SOUTH BEND, IN
ZIP 46601-171
Phone: (574) 647-5300
Fax: (574) 647-5305

The NPI 1912112384 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)

The enumeration date for this NPI number is 5/11/2007 and was last updated on 3/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery02004231AINDIANANo
2207XX0801XOrthopaedic SurgeryOrthopaedic Trauma02004231AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1169380062OTHERINDIANAMEDICARE PTAN
2233530013OTHERINDIANAMEDICARE PTAN
3247000020OTHERINDIANAMEDICARE PTAN
4P01340628OTHERINDIANARR MEDICARE
5000000831457OTHERINDIANABCBS BMG ORTHOPEDIC TRAUMA
6236040223OTHERINDIANAMEDICARE PTAN
7201175680MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.