Individual provider Active NPI

Louis Profeta, MD

  • Emergency Medicine Physician
  • Panama City, FL
National Provider Identifier
1063506830
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME164638 Issued in FL
Practice address
615 N Bonita Ave
Panama City, FL 32401-3623
Phone
(850) 769-1511
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01041413 IN
Emergency Medicine Physician 207P00000X ME164638 FL Primary

Addresses

Primary practice location

615 N Bonita Ave
Panama City, FL 32401-3623

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411

Other practice location 1

11111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2448
Phone (850) 769-1511

Other practice location 2

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 802-3140

Other practice location 3

3801 E Highway 98
Port St Joe, FL 32456-5318
Phone (806) 853-7111

Other identifiers 1

IdentifierTypeStateIssuer
100338950MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090413000151 IN Practitioner - Emergency Medicine 9830171537 Reassigns benefits to 1 organization
I20260128003324 FL Practitioner - Emergency Medicine 9830171537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

615 N Bonita Ave
Panama City, FL 32401-3623
Phone (850) 769-1511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME164638FLMDEmergency Medicine Physician
01041413INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 22, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

11111 Panama City Beach Pkwy
Panama City Beach, FL 32407
Phone (850) 236-8655

3801 E Highway 98
Port St Joe, FL 32456
Phone (850) 229-5600

9613 E US Highway 36
Avon, IN 46123
Phone (317) 415-5980

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8451 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 884-7540

8602 Allisonville Rd
Indianapolis, IN 46250
Phone (317) 703-1970

1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1063506830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-769-1511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11111 Panama City Beach Pkwy",
            "address_purpose": "LOCATION",
            "city": "Panama City Beach",
            "state": "FL",
            "postal_code": "324072448",
            "country_code": "US",
            "telephone_number": "850-769-1511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-802-3140",
            "fax_number": "317-870-0499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 E Highway 98",
            "address_purpose": "LOCATION",
            "city": "Port St Joe",
            "state": "FL",
            "postal_code": "324565318",
            "country_code": "US",
            "telephone_number": "806-853-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROFETA",
        "first_name": "LOUIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01041413",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME164638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100338950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.