Individual provider Active NPI

Cody Marie Elmore, MD

  • Emergency Medicine Physician
  • Lafayette, IN
National Provider Identifier
1174725279
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01062434A Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904-2477
Phone
(765) 448-8000
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01062434A IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2477

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other identifiers 2

IdentifierTypeStateIssuer
000000586464OtherINANTHEM PROVIDER NUMBER
200902940MedicaidIN

Other names 1

  • Cody Marie Bertsch Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080714000411 IN Practitioner - Emergency Medicine 9739252453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Emergency Physicians IncGroup PAC ID 9931172863, 22 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone (317) 392-3211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062434AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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 4

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1174725279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042477",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "CODY",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01062434A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000586464",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200902940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CODY",
            "last_name": "BERTSCH",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.