Individual provider Active NPI

Edward Resendez, PA

  • Physician Assistant
  • Decatur, IN
National Provider Identifier
1255904983
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003291A Issued in IN
Practice address
1100 Mercer Ave
Decatur, IN 46733-2303
Phone
(260) 724-2145
NPI assigned
Jul 21, 2021
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003291A IN Primary

Addresses

Primary practice location

1100 Mercer Ave
Decatur, IN 46733-2303

Mailing address

PO Box 151
Decatur, IN 46733-0151
Phone (260) 724-2145

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220110000576 IN Practitioner - Physician Assistant 9830581560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams County Memorial HospitalGroup PAC ID 0941198253, 85 clinicians

Practice addresses (Care Compare)

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 724-2145

1401 N 13TH St
Suite 200
Decatur, IN 46733-3139
Phone (260) 724-2145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Memorial Hospital CurrentSince Oct 9, 2021 Accepting new patients
Adams County Memorial Hospital CurrentSince Oct 9, 2021 Accepting new patients
Adams County Memorial Hospital Past Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

1401 N 13th St
Ste 200
Decatur, IN 46733

205 Tower Dr
Monroe, IN 46772
Phone (260) 692-6163

Interoperability endpoints

  • Direct secure messaging: eresendez467775@direct.parkviewexchange.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.

Hospital & facility affiliations 1

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": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1255904983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467330151",
            "telephone_number": "260-724-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "260-724-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESENDEZ",
        "first_name": "EDWARD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003291A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

Verify at the official NPI Registry.