NPIMap

Individual provider Active NPI

Maria Lee Glass, MD

  • Family Medicine Physician
  • Corydon, IN
National Provider Identifier
1306034566
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01066600A Issued in IN
Practice address
313 Federal Dr NW
Suite 200
Corydon, IN 47112-3070
Phone
(812) 738-4155
Fax
(812) 738-6104
NPI assigned
Oct 11, 2007
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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 01066600A IN Primary

Addresses

Primary practice location

313 Federal Dr NW
Suite 200
Corydon, IN 47112-3070

Mailing address

313 Federal Dr NW
Suite 200
Corydon, IN 47112-3070
Phone (812) 738-4155

Other identifiers 1

IdentifierTypeStateIssuer
616162OtherINANTHEM

Other names 1

  • Maria Lee De la Cruz Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdelacruz20506@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090623000529 IN Practitioner - Family Practice 6103977608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1373 E State Rd
Madison, IN 47250-7328
Phone (812) 801-0810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01066600AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2016 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2016 Accepting new patients

Locations

313 Federal Dr NW
Ste 200
Corydon, IN 47112
Phone (812) 738-4155

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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 8

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1306034566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 FEDERAL DR NW",
            "address_2": "SUITE 200",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471123070",
            "telephone_number": "812-738-4155",
            "fax_number": "812-738-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 FEDERAL DR NW",
            "address_2": "SUITE 200",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471123070",
            "telephone_number": "812-738-4155",
            "fax_number": "812-738-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "MARIA",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01066600A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "616162",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdelacruz20506@bhkydirect.com",
            "affiliation": "N",
            "address_1": "313 Federal Dr NW",
            "address_2": "Suite 200",
            "city": "Corydon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471123070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "DE LA CRUZ",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.