Active NPI
Lyle R Cortez, D.O.
- Family Medicine Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02004147A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201092820 | Medicaid | IN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 LLCShalom Health Care Center Inc
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02004147A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Vein Restoration in, LLC | Current | Accepting new patients | |
| Center for Vein Restoration in, LLC | Current | Accepting new patients | |
| Shalom Health Care Center, Inc. | Family Medicine | Current | Accepting new patients |
| Shalom Health Care Center, Inc. | Family Medicine | Current | 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
- https://fhir4.healow.com/fhir/r4/BAJHAA
- 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.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1992924633
Family Medicine, IN
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Hobart, IN
- NPI 1790653897
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1003275512
Family Medicine
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1770267486
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jeffersonville, IN
- NPI 1013885110
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Fort Wayne, IN
- NPI 1255209342
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Evansville, IN
- NPI 1528936614
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Indianapolis, IN
- NPI 1649148735
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Munster, IN
- NPI 1770451874
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1982242327
Family Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.