Individual provider Active NPI

Cortney Sloan Palencia, D.O.

  • Emergency Medicine Physician
  • Hammond, IN
National Provider Identifier
1114304466
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02006063A Issued in IN
Practice address
5454 Hohman Ave
Hammond, IN 46320-1931
Phone
(219) 932-2300
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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 036149424 IL
Emergency Medicine Physician 207P00000X 02006063A IN Primary

Addresses

Primary practice location

5454 Hohman Ave
Hammond, IN 46320-1931

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other practice location 1

20201 Crawford Ave
Olympia Fields, IL 60461
Phone (708) 747-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190613001370 IL Practitioner - Emergency Medicine 3870881329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Emergency Care Management IncGroup PAC ID 1850387713, 11 clinicians

Practice addresses (Care Compare)

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4009

Hospital & facility affiliations

  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.45
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Emergency Physicians, LLC Emergency Medicine CurrentSince May 22, 2019 Accepting new patients
Aurora Emergency Physicians, LLC Emergency Medicine CurrentSince May 22, 2019 Accepting new patients

Locations

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1114304466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201931",
            "telephone_number": "219-932-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20201 Crawford Ave",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "60461",
            "country_code": "US",
            "telephone_number": "708-747-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALENCIA",
        "first_name": "CORTNEY",
        "middle_name": "SLOAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036149424",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02006063A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.