Individual provider Active NPI

Laine Elam, PAC

  • Physician Assistant
  • Muncie, IN
National Provider Identifier
1265516751
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000270A Issued in IN
Practice address
2525 W University Ave Ste 402
Muncie, IN 47303-3409
Phone
(765) 747-6090
Fax
(765) 747-5069
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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 10000270A IN Primary

Addresses

Primary practice location

2525 W University Ave Ste 402
Muncie, IN 47303-3409

Mailing address

3500 W Purdue Ave
Muncie, IN 47304-6357
Phone (765) 747-6090

Other names 1

  • Laine Beaty Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MT, WY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040505000656 IN Practitioner - Physician Assistant 6709874944 Reassigns benefits to 1 organization
I20190605002683 MT Practitioner - Physician Assistant 6709874944 Reassigns benefits to 1 organization
I20191001002792 WY Practitioner - Physician Assistant 6709874944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings Dermatology PCGroup PAC ID 1951718170, 4 clinicians

Practice addresses (Care Compare)

2294 Grant Rd
Billings, MT 59102-7423
Phone (406) 294-9515

400 S 15TH St
Worland, WY 82401-3531
Phone (406) 294-9515

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000270AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Dermatology PC CurrentSince May 1, 2021 Accepting new patients
Emergency Physicians of Delaware County, P.C. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2294 Grant Rd
Billings, MT 59102
Phone (406) 294-9515

2107 Sheridan Ave
Cody, WY 82414
Phone (307) 586-5303

777 Avenue H
Bldg A
Powell, WY 82435

1106 Big Horn Ave
Worland, WY 82401
Phone (307) 347-3221

400 S 15th St
Worland, WY 82401
Phone (307) 347-3221

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1265516751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046357",
            "telephone_number": "765-747-6090",
            "fax_number": "765-747-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W UNIVERSITY AVE STE 402",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033409",
            "telephone_number": "765-747-6090",
            "fax_number": "765-747-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "LAINE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000270A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAINE",
            "last_name": "BEATY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.