Ellen Michele Cooper, MD
Individual provider Active NPI Surgery Physician · Truckee, CA
NPI 1003920596 · NPPES record last updated Feb 16, 2012
Key facts
- NPI
- 1003920596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- A116674 (CA)
- Practice address
- 10051 Lake Ave Ste 4
Truckee, CA 96161-4870 - Phone
- (530) 587-7698
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Rochester School of Medicine and Dentistry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tahoe Forest Hospital District
Practice addresses (Care Compare)
10051 Lake Ave
Suite 3
Truckee, CA 96161-4870
Phone (530) 587-7461
10121 Pine Ave
Truckee, CA 96161-4835
Phone (530) 587-6011
Hospital & facility affiliations
- Tahoe Forest Hospital
- Incline Village Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.06 of 100
- Quality
- 83.97
- Promoting interoperability
- 88
- Improvement activities
- 40
- Cost
- 42.89
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111017000177 | CA | Practitioner - General Surgery | 4587798202 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A116674 | CA | MD | Surgery Physician |
| ML20008204 | WA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tahoe Forest Hospital District | Current | Accepting new patients | |
| Tahoe Forest Hospital District | Current |
Accepting new patients | |
| Tahoe Forest Hospital District | Current |
Accepting new patients |
Locations
10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461
10051 Lake Ave
Ste 4
Truckee, CA 96161
Phone (530) 582-0202
10121 Pine Ave
Fl 2
Truckee, CA 96161
Phone (530) 582-6368
10956 Donner Pass Rd
Ste 230
Truckee, CA 96161
Phone (530) 582-3277
10956 Donner Pass Rd
Ste 210
Truckee, CA 96161
Phone (530) 550-8189
10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220
Interoperability endpoints
- ecooper958380@directa.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ML20008204 | WA | |
| Surgery Physician | 208600000X | A116674 | CA | Yes |
Addresses
Primary practice location
10051 Lake Ave Ste 4
Truckee, CA 96161-4870
Mailing address
10051 Lake Ave Ste 4
Truckee, CA 96161-4870
Phone (530) 587-7698
Other providers in Truckee, CA
- Robert Joseph Colpitts Jr.
- Lorraine Hanlon Comanor
- Karla Marina Combs
- Sailys Concepcion
- Haley Congistre
- Vron Mikell Cooper
- Rebecca A Cordero
- Yulian Navarro Cordero
- Lizbeth Cortez Sosa
- Hannah Jeanne Cox
All providers in Truckee, CA · Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.