KAEDON IZAAC BUCHMILLER DO
NPI 1417746090
Student in an Organized Health Care Education/Training Program in South Bend, IN

Q: What is Kaedon Buchmiller's NPI number?

The NPI number for Kaedon Buchmiller is 1417746090. It was assigned to this individual provider in the NPPES registry on May 1, 2025.

Q: What is Kaedon Buchmiller's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kaedon Buchmiller was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 01, 2025PECOS Enrolled

714 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-6819(574) 647-6819 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kaedon Izaac Buchmiller Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAEDON IZAAC BUCHMILLER DO (NPI 1417746090) is an individual student in an organized health care education/training program in South Bend, Indiana and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417746090

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKAEDON IZAAC BUCHMILLERCredential: DO

Location Address714 N MICHIGAN STSouth Bend, IN 46601-1035

Mailing Address714 N Michigan StSouth Bend, IN 46601-1035 · (574) 647-6819

Phone(574) 647-6819

Fax(574) 647-6819

Sole ProprietorNo

Enumeration DateMay 1, 2025

NPPES CertifiedMay 1, 2025

✔ NPI 1417746090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

714 N MICHIGAN ST, South Bend, IN 46601

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaedon Izaac Buchmiller Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID HENRY TALARICO MD

Student in an Organized Health Care Education/Training Program