Individual provider Active NPI

Ivan J Elias, MD

  • Gastroenterology Physician
  • Pensacola, FL
National Provider Identifier
1255337879
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME159213 Issued in FL
Practice address
125 Baptist Way Ste 4C
Pensacola, FL 32503-2254
Phone
(850) 626-9626
NPI assigned
Jun 28, 2005
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME159213 FL Primary

Addresses

Primary practice location

125 Baptist Way Ste 4C
Pensacola, FL 32503-2254

Mailing address

PO Box 732892
Dallas, TX 75373-1149

Other identifiers 3

IdentifierTypeStateIssuer
209679000MedicaidMO
100321540AMedicaidKS
110126494OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100823001082 MO Practitioner - GastroenterologyPractitioner - Internal Medicine 2365464294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Creighton University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13900 Belinder St
Leawood, KS 66224-3935

9825 Jordan Gateway
South Jordan, UT 84095

PO Box
Suite 95590
South Jordan, UT 84095

PO Box
Suite 95590
South Jordan, UT 84095-0590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.01 of 100Reported as group
Quality
62.34
Promoting interoperability
95
Improvement activities
40
Cost
78.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy67
Upper gastrointestinal (GI) endoscopy for acid reflux62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME159213FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cass Regional Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Cass Regional Medical Center CurrentSince Jun 1, 2022 Accepting new patients

Locations

2800 E Rock Haven Rd
Harrisonville, MO 64701
Phone (816) 380-3474

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

2330 E Meyer Blvd
Ste 301
Kansas City, MO 64132
Phone (816) 333-5424

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1255337879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732892",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BAPTIST WAY STE 4C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-626-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "IVAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME159213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209679000",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100321540A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110126494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.