NPIMap

Individual provider Active NPI

Richard A Defelice, MD

  • Emergency Medicine Physician
  • Vincennes, IN
National Provider Identifier
1326033770
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01039027 Issued in IN
Practice address
520 S 7TH St
Vincennes, IN 47591-1038
Phone
(812) 882-5220
Fax
(812) 885-3811
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01039027 IN Primary

Addresses

Primary practice location

520 S 7TH St
Vincennes, IN 47591-1038

Mailing address

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3685

Other identifiers 1

IdentifierTypeStateIssuer
200056750MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050324000112 MN Practitioner - Family PracticePractitioner - Emergency Medicine 4587610431 Reassigns benefits to 2 organizations
I20050714000807 IN Practitioner - Emergency MedicinePractitioner - Family Practice 4587610431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Emergency Medicine IncGroup PAC ID 1052666575, 16 clinicians

Practice addresses (Care Compare)

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01039027INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Emergency Medicine, Inc. CurrentSince Aug 15, 2018 Accepting new patients
Indiana Emergency Professionals PC Emergency Medicine CurrentSince Apr 18, 2016 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 11, 2009 Accepting new patients
Ely-Bloomenson Community Hospital Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 11, 2009 Accepting new patients
Lifecare Medical Center CurrentSince Feb 23, 2013 Accepting new patients
Lifecare Medical Center CurrentSince Feb 23, 2013 Accepting new patients
Indiana University Health Paoli Inc Past Accepting new patients

Locations

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

520 S 7th St
Unit Er
Vincennes, IN 47591
Phone (812) 885-3292

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

328 W Conan St
Ely, MN 55731
Phone (218) 365-3271

712 S Cascade St
Fergus Falls, MN 56537

715 Delmore Dr
Roseau, MN 56751
Phone (218) 463-2500

412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1326033770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-885-3685",
            "fax_number": "812-885-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-882-5220",
            "fax_number": "812-885-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01039027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200056750",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.