NPIMap

Individual provider Active NPI

Iass El Lakkis, MD

  • Infectious Disease Physician
  • Evansville, IN
National Provider Identifier
1205065737
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
46817 Issued in KY
Practice address
520 Mary St Ste 230
Evansville, IN 47710-1678
Phone
(812) 450-8600
Fax
(812) 450-8151
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 46817 KY Primary

Addresses

Primary practice location

520 Mary St Ste 230
Evansville, IN 47710-1678

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

Other practice location 1

250 Park St
The Medical Canter
Bowling Green, KY 42101-1760
Phone (270) 745-1268

Other practice location 2

720 2nd Ave Ste 307
Bowling Green, KY 42101-1718
Phone (270) 780-2760

Other identifiers 1

IdentifierTypeStateIssuer
7100331430MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140924002290 KY Practitioner - Infectious Disease 0840419834 Reassigns benefits to 1 organization
I20200804003698 IN Practitioner - Infectious Disease 0840419834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

Practice addresses (Care Compare)

1300 Merritt Dr
Henderson, KY 42420-2788
Phone (270) 827-0064

520 Mary St
Suite 230
Evansville, IN 47710-1678
Phone (812) 450-8600

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319
  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056
  • Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093
  • Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Infectious Disease CurrentSince Aug 1, 2020 Accepting new patients
Deaconess Clinic, Inc Current Accepting new patients
Deaconess Clinic Inc. Infectious Disease Current Accepting new patients
Deaconess Clinic Inc CurrentSince Aug 1, 2020 Accepting new patients
Deaconess Clinic, Inc CurrentSince Dec 5, 2024 Accepting new patients

Locations

520 Mary St
Ste 230
Evansville, IN 47710
Phone (812) 450-8600

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1300 Merritt Dr
Henderson, KY 42420
Phone (270) 824-0064

1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031

Interoperability endpoints

  • Direct secure messaging: iellakkis220160@direct.deaconess.com

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 11

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1205065737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101678",
            "telephone_number": "812-450-8600",
            "fax_number": "812-450-8151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Park St",
            "address_2": "The Medical Canter",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421011760",
            "country_code": "US",
            "telephone_number": "270-745-1268",
            "fax_number": "270-780-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 2nd Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421011718",
            "country_code": "US",
            "telephone_number": "270-780-2760",
            "fax_number": "270-780-2761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL LAKKIS",
        "first_name": "IASS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "46817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100331430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.