Individual provider Active NPI

Chelsea Faye Kolodziej, DO

  • Family Medicine Physician
  • Marion, IN
National Provider Identifier
1407484264
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02006617A Issued in IN
Practice address
441 N Wabash Ave
Marion, IN 46952-2690
Phone
(765) 660-6000
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 02006617A IN Primary

Addresses

Primary practice location

441 N Wabash Ave
Marion, IN 46952-2690

Mailing address

441 N Wabash Ave
Marion, IN 46952-2690
Phone (765) 660-6000

Other practice location 1

2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 741-1515

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL MGH

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
I20220425000541 IN Practitioner - Family Practice 5496146839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

1411 W Bella Dr
Family Medicine Residency
Marion, IN 46953-5250
Phone (765) 660-7790

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02006617AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion General Hospital Family Medicine Current Accepting new patients
Marion General Hospital CurrentSince May 11, 2023 Accepting new patients
Marion General Hospital CurrentSince May 11, 2023 Accepting new patients
Indiana University Health Ball Memorial Physicians, Inc. Family Medicine CurrentSince Jun 19, 2022 Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

911 Marion Health Dr
Gas City, IN 46933
Phone (765) 660-7000

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1389 N Baldwin Ave
Marion, IN 46952
Phone (765) 664-2671

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

Organizations & group practices 4

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 4

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1407484264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522690",
            "telephone_number": "765-660-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522690",
            "telephone_number": "765-660-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W University Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473033428",
            "country_code": "US",
            "telephone_number": "765-741-1515",
            "fax_number": "765-751-5087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLODZIEJ",
        "first_name": "CHELSEA",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02006617A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "MGH",
            "affiliation": "N",
            "address_1": "441 N Wabash Ave",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469522690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.