Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mathew Jose Kallookulangara, MD

Individual provider Internal Medicine Physician · NPI 1912998642

Mathew Jose Kallookulangara, MD is an Internal Medicine in South Bend, Indiana. Qualified in 2001, 25 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
25
Licensed in
IN
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

615 N Michigan St Fl 1
South Bend, IN 46601-1033
Phone: (574) 647-3050
Fax: (574) 647-1094
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 01059944A (IN)

Record details

NPI number1912998642
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 2, 2005
Last updated in NPPESMarch 31, 2021
Certification dateMarch 31, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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