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KAYTI LYNN BONCZYNSKI NP
NPI 1619425980
Nurse Practitioner - Family in South Bend, IN

Active since September 15, 2016PECOS EnrolledAccepts Medicare Assignment
621 MEMORIAL DR STE 402, SOUTH BEND, IN 46601(574) 400-4550(574) 400-4551 Get Directions Write a Review

NPPES record last updated: January 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2023, Jun 2, 2021, Feb 10, 2021 and 1 more (4 updates tracked since 2016).

About Kayti Lynn Bonczynski Np NPPES

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

KAYTI LYNN BONCZYNSKI NP (NPI 1619425980) is an individual family provider in South Bend, Indiana, licensed in Indiana (71006807A) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of South Bend, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1619425980
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKAYTI LYNN BONCZYNSKICredential: NP
Location Address621 MEMORIAL DR STE 402South Bend, IN 46601-1074
Mailing Address621 Memorial Dr Ste 402South Bend, IN 46601-1074 · (574) 400-4550 · Fax (574) 400-4551
Phone(574) 400-4550
Fax(574) 400-4551
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateSeptember 15, 2016
Last NPPES UpdateJanuary 3, 20234 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2023
✔ NPI 1619425980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IN · 71006807A
621 MEMORIAL DR STE 402, South Bend, IN 46601
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1420 W 4th StMishawaka, IN 46544-1948 · Phone (574) 307-7673 · Fax (574) 307-7692
Location 252500 Fir RdGranger, IN 46530-8579 · Phone (574) 271-0700 · Fax (574) 273-5648

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kayti Lynn Bonczynski Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305129867
PECOS Enrollment IDI20170207000895
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Of South Bend

Acute Care Hospitals · South Bend, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150058
Location615 N Michigan StSouth Bend, IN 46601 · St. Joseph County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

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

CHRISTINE ELIZABETH COULTER MSN, FNP
Nurse Practitioner (Family)
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550
CAROLYN HORIN FNP-C
Nurse Practitioner (Family)
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550
MR. PAUL BRIAN SEXTON LCSW
Social Worker (Clinical)
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 280-8199
MARJORIE THERMIDOR DAOUD MD
Internal Medicine (Infectious Disease)
621 MEMORIAL DR STE 402, MEMORIAL HOSPITAL
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2500
MICHAEL SEAN KOZAK MD
Family Medicine
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550
DR. MARY HOPE GRIFFIN M.D.
Pediatrics
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550
BRANDON WILLIAM ZABUKOVIC M.D.
Family Medicine
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550
JENNIFER MARIE BEAM FNP
Nurse Practitioner (Family)
621 MEMORIAL DR STE 402
SOUTH BEND, IN 46601
St. Joseph County (574) 400-4550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kayti Bonczynski's NPI number?

The NPI number for Kayti Bonczynski is 1619425980. It was assigned to this individual provider in the NPPES registry on September 15, 2016.

Where is Kayti Bonczynski located?

Kayti Bonczynski practices at 621 Memorial Dr Ste 402, South Bend, IN 46601. The listed phone number is (574) 400-4550.

What is Kayti Bonczynski's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kayti Bonczynski enrolled in Medicare?

Yes. Kayti Bonczynski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kayti Bonczynski accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Kayti Bonczynski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kayti Bonczynski affiliated with any hospitals?

According to CMS data, Kayti Bonczynski is affiliated with Memorial Hospital Of South Bend.

When was this NPI record last updated?

The NPPES record for Kayti Bonczynski was last updated on January 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.