Active NPI
Rose Paul
- Family Medicine Physician
- Kokomo, IN
National Provider Identifier
1164759106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01054569A
- Practice address
- 138 N Dixon Rd
Kokomo, IN 46901-4154 - Phone
- (765) 236-8282
- NPI assigned
- Nov 12, 2009
- Last updated
- Aug 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01054569A | IN | Primary |
Addresses
Primary practice location
138 N Dixon Rd
Kokomo, IN 46901-4154
Mailing address
138 N Dixon Rd
Kokomo, IN 46901-4154
Other practice location 1
3301 County Road 6 E
Elkhart, IN 46514-7673
Phone (574) 266-5342
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200969560 | Medicaid | IN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | PAUL@mybeacon.cernerdirect.com | ||
| Direct Messaging Address | rose.paul.1@7598.direct.athenahealth.com | St. Vincent Medical Group, Inc. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
138 N Dixon Rd
Kokomo, IN 46901-4154
Phone (765) 236-8282
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Medical Group Inc | Past | Accepting new patients | |
| West Suburban Medical Center | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- paul@mybeacon.cernerdirect.com
- rose.paul.1@7598.direct.athenahealth.com
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.
-
dba Ascension Medical Group St. Vincent
- Orthopaedic Surgery Physician
- Winchester, IN
- NPI 1144513375
-
- Cardiovascular Disease Physician
- Indianapolis, IN
- NPI 1558686436
-
dba West Suburban Health Care Physicians SVCS
- Family Medicine Physician
- Chicago, IL
- NPI 1649499096
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Elara Caring
- Home Health Agency
- Kokomo, IN
- NPI 1346255940
-
- Home Health Agency
- Carmel, IN
- NPI 1740630110
-
- Critical Access Hospital
- Frankfort, IN
- NPI 1346774270
-
dba Ascension St. Vincent Kokomo
- General Acute Care Hospital
- Kokomo, IN
- NPI 1780625442
-
dba Ascension at Home
- Home Health Agency
- Pendleton, IN
- NPI 1942376843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1164759106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 N DIXON RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469014154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 N DIXON RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469014154",
"telephone_number": "765-236-8282"
}
],
"practiceLocations": [
{
"address_1": "3301 County Road 6 E",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465147673",
"country_code": "US",
"telephone_number": "574-266-5342",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAUL",
"first_name": "ROSE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01054569A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200969560",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "PAUL@mybeacon.cernerdirect.com",
"affiliation": "N",
"address_1": "3301 County Road 6 E",
"city": "Elkhart",
"state": "IN",
"country_code": "US",
"postal_code": "465147673",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rose.paul.1@7598.direct.athenahealth.com",
"affiliation": "Y",
"affiliationName": "St. Vincent Medical Group, Inc.",
"address_1": "138 N Dixon Rd",
"city": "Kokomo",
"state": "IN",
"country_code": "US",
"postal_code": "469014154",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.