Jaseena Elikkottil, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

49109 Issued in KY

Practice address

4805 Southside Dr
Louisville, KY 40214-2111

Phone

(502) 772-8860

Fax

(502) 996-8309

NPI assigned

Mar 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers IncGroup PAC ID 6901700053, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.96 of 100Reported as group

Quality

56.12

Promoting interoperability

100

Improvement activities

40

Cost

73.73

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaseena.elikkottil@fhci.eclinicaldirectplus.com
• Direct secure messaging: jelikkottil119678@direct.nortonhealthcare.org

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.

• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1649732603
  Medicare reassignment Care Compare group NPD
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316
  Medicare reassignment NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1104879469
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1134172489
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205689064
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205889540
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fairdale, KY
  • NPI 1871546119
  NPD
• University of Louisville Physicians, Inc.

  • Radiation Oncology Physician
  • Louisville, KY
  • NPI 1124375936
  NPD
• University of Louisville Physicians, Inc.

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• Family Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1942954441
  NPD (past)
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1356394670
  NPD (past)
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1427574862
  NPD (past)

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1407096233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950244",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950244",
            "telephone_number": "502-953-4700",
            "fax_number": "502-953-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 SOUTHSIDE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142111",
            "telephone_number": "502-772-8860",
            "fax_number": "502-996-8309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Chestnut St",
            "address_2": "Svc Bldg, Ste 303",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021831",
            "country_code": "US",
            "telephone_number": "502-629-5552",
            "fax_number": "502-629-3132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Chestnut St",
            "address_2": "Svc Bldg, Ste 303",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021831",
            "country_code": "US",
            "telephone_number": "502-629-5552",
            "fax_number": "502-629-3132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIKKOTTIL",
        "first_name": "JASEENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "49109",
            "primary": false
        },
        {
            "code": "246RH0600X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Histology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "22544",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "49109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100437200",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201407600",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanany Elghaouth
• Oktaviani Eli, RBT
• James Roscoe Elias Jr., D.M.D.
• Rachel Elias
• Emily Elizabeth Elieff
• Ronald J. Elin, M.D., PHD
• Michelle Eileen Elisburg, MD
• Elite Clinical Laboratory
• Elite Performance Physical Therapy
• Elite Surgical Assistants, Inc

• Internal Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.

Verify at the official NPI Registry.