Individual provider Active NPI

Ellen Michele Cooper, MD

  • Surgery Physician
  • Truckee, CA
National Provider Identifier
1003920596
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A116674 Issued in CA
Practice address
10051 Lake Ave Ste 4
Truckee, CA 96161-4870
Phone
(530) 587-7698
NPI assigned
Aug 19, 2006
Last updated
Feb 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ML20008204 WA
Surgery Physician 208600000X A116674 CA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000177 CA Practitioner - General Surgery 4587798202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 DistrictGroup PAC ID 0446161335, shared by 12 NPIs, 140 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
75.06 of 100Reported as group
Quality
83.97
Promoting interoperability
88
Improvement activities
40
Cost
42.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116674CAMDSurgery Physician
ML20008204WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District Current Accepting new patients
Tahoe Forest Hospital District CurrentSince Aug 31, 2011 Accepting new patients
Tahoe Forest Hospital District CurrentSince Aug 31, 2011 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
Truckee, CA 96161
Phone (530) 582-3220

10121 Pine Ave
Fl 2
Truckee, CA 96161
Phone (530) 550-6770

10956 Donner Pass Rd
Ste 210
Truckee, CA 96161
Phone (530) 550-8189

10956 Donner Pass Rd
Ste 230
Truckee, CA 96161
Phone (530) 582-3277

Interoperability endpoints

  • Direct secure messaging: ecooper958380@directa.mercy.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1003920596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 LAKE AVE STE 4",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614870",
            "telephone_number": "530-587-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051 LAKE AVE STE 4",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614870",
            "telephone_number": "530-587-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELLEN",
        "middle_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML20008204",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A116674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.