Individual provider Active NPI

Lyle R Cortez, D.O.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1295960805
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02004147A Issued in IN
Practice address
3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147
Phone
(317) 291-7422
Fax
(317) 291-7433
NPI assigned
May 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02004147A IN Primary

Addresses

Primary practice location

3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147

Mailing address

33 E County Line Rd Ste D
Greenwood, IN 46143-1078
Phone (317) 644-6355

Other practice location 1

105 S Raceway Rd Ste 135
Indianapolis, IN 46231-1417
Phone (317) 644-6355

Other practice location 2

33 E County Line Rd Ste D
Greenwood, IN 46143-1078
Phone (317) 644-6355

Other identifiers 1

IdentifierTypeStateIssuer
201092820MedicaidIN

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
I20150410002415 IN Practitioner - Family Practice 1759523905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Vein Restoration in LLCGroup PAC ID 8426356528, 11 clinicians
Shalom Health Care Center IncGroup PAC ID 3779471750, 5 clinicians

Practice addresses (Care Compare)

105 S Raceway Rd
Suite 135
Indianapolis, IN 46231-1417
Phone (855) 830-8346

3400 Lafayette Rd
Suite 200
Indianapolis, IN 46222-1147
Phone (317) 291-7422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004147AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration in, LLC CurrentSince Mar 9, 2026 Accepting new patients
Center for Vein Restoration in, LLC CurrentSince Mar 9, 2026 Accepting new patients
Shalom Health Care Center, Inc. Family Medicine CurrentSince Jul 23, 2021 Accepting new patients
Shalom Health Care Center, Inc. Family Medicine CurrentSince Jul 23, 2021 Accepting new patients
Shalom Health Care Center, Inc. Family Medicine Past Accepting new patients
Major Hospital Past Accepting new patients
Shalom Health Care Center, Inc. Past Accepting new patients

Locations

6540 Logan Dr
Ste 2
Evansville, IN 47715
Phone (812) 474-1400

33 E County Line Rd
Ste D
Greenwood, IN 46143
Phone (317) 644-6355

105 S Raceway Rd
Ste 135
Indianapolis, IN 46231
Phone (317) 203-7970

5750 W 56th St
Indianapolis, IN 46254
Phone (317) 291-1411

3400 Lafayette Rd
Ste 200
Indianapolis, IN 46222
Phone (317) 829-5747

5801 E 30th St
#99
Indianapolis, IN 46218
Phone (317) 226-4299

9240 N Meridian St
Ste 180
Indianapolis, IN 46260
Phone (317) 582-1100

3400 Lafayette Rd
Indianapolis, IN 46222
Phone (317) 293-4113

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAJHAA
  • Direct secure messaging: lyle.cortez@shalomhcc.eclinicaldirectplus.com

Organizations & group practices 12

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1295960805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E COUNTY LINE RD STE D",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431078",
            "telephone_number": "317-644-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Raceway Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462311417",
            "country_code": "US",
            "telephone_number": "317-644-6355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 E County Line Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431078",
            "country_code": "US",
            "telephone_number": "317-644-6355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "LYLE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004147A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201092820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.