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JAMES W KOZELKA MD
NPI 1720016926
Psychiatry & Neurology - Neurology in South Bend, IN

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
100 NAVARRE PL STE 4400, SOUTH BEND, IN 46601(574) 647-2501(574) 647-2506 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 18, 2026, Mar 11, 2025, Dec 6, 2023 and 3 more (6 updates tracked since 2020).

About James W Kozelka Md NPPES

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

JAMES W KOZELKA MD (NPI 1720016926) is an individual neurology provider in South Bend, Indiana, licensed in Indiana (01038371A) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Franciscan Health Michigan City, and maintains a secondary practice location in Mishawaka.

NPPES Registry Identity

NPI1720016926
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameJAMES W KOZELKACredential: MD
Location Address100 NAVARRE PL STE 4400South Bend, IN 46601-1100
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380
Phone(574) 647-2501
Fax(574) 647-2506
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1984
Enumeration DateJune 28, 2006
Last NPPES UpdateMay 18, 20266 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1720016926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in IN · 01038371A
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · Sleep MedicineTaxonomy 2084S0012X · License 01038371A (IN)
100 NAVARRE PL STE 4400, South Bend, IN 46601
Open in Google Maps ↗

Secondary Practice Location 1

Location 15314 Lincolnway EMishawaka, IN 46544-4249 · Phone (574) 647-8542 · Fax (574) 647-8549

Other Identifiers 1

Medicaid100317840IN

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James W Kozelka Md 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 ID5991601999
PECOS Enrollment IDI20040511000377
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.

Medicare Billing Reassignment

Medicare enrollment records show James Kozelka reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beacon Medical Group, Inc.
Same address
Pediatrics
100 NAVARRE PL STE 5550
South Bend, IN 46601
  • Reassigned Medicare billing, Indiana enrollment
  • 734 clinicians in this Medicare group
NPI 1548415474 (574) 647-2550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, onabotulinumtoxina, 1 unit J0585
Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
8,400 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
274 services172 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
104 services104 patients
Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face 64615
This procedure involves injecting a chemical into specific facial and neck muscles, causing temporary paralysis. This helps reduce muscle activity and can alleviate certain medical conditions. Both sides of the face are treated for a balanced result.
42 services19 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
24 services24 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Franciscan Health Michigan City

Acute Care Hospitals · Michigan City, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150015
Location3500 Franciscan WayMichigan City, IN 46360 · La Porte County
Emergency services Birthing friendly

Elkhart General Hospital

Acute Care Hospitals · Elkhart, IN
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number150018
Location600 E BlvdElkhart, IN 46514 · Elkhart County
Emergency services Birthing friendly

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

Community Hospital Of Bremen Inc

Critical Access Hospitals · Bremen, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151300
Location1020 High RdBremen, IN 46506 · Marshall County
Emergency services

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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
1%396 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
0%792 patients1/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
65%37 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%3,324 patients5/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
2%620 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
21%1,501 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 959 patients
Patients tobacco: 13% · 125 patients
88%959 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
7 suppliers37 claims37 services$34.17 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers73 claims73 services$82.14 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
9 suppliers75 claims206 services$31.07 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers26 claims142 services$14.36 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
7 suppliers32 claims32 services$49.24 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
9 suppliers67 claims67 services$17.69 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

BEACON MEDICAL GROUP, INC.
Internal Medicine (Nephrology)
100 NAVARRE PL STE 4400
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1972
LESLIE NICOLE KANIUK NP
Nurse Practitioner (Family)
100 NAVARRE PL STE 4400
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2501

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 James Kozelka's NPI number?

The NPI number for James Kozelka is 1720016926. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is James Kozelka located?

James Kozelka practices at 100 Navarre Pl Ste 4400, South Bend, IN 46601. The listed phone number is (574) 647-2501.

What is James Kozelka's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is James Kozelka enrolled in Medicare?

Yes. James Kozelka 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.

Which organization bills Medicare for James Kozelka's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Kozelka reassigns Medicare benefits to Beacon Medical Group, Inc. (South Bend, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Kozelka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Kozelka accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list James Kozelka 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 James Kozelka affiliated with any hospitals?

According to CMS data, James Kozelka is affiliated with Franciscan Health Michigan City, Elkhart General Hospital, Memorial Hospital Of South Bend and Community Hospital Of Bremen Inc.

When was this NPI record last updated?

The NPPES record for James Kozelka was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.