Individual provider Active NPI

Ellen Elizabeth Cuddeback, D.O.

  • Obstetrics & Gynecology Physician
  • Lansing, MI
National Provider Identifier
1497053599
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101027648 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-1000
NPI assigned
Mar 14, 2011
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 02004563A IN
Obstetrics & Gynecology Physician 207V00000X 5101027648 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

1215 E Michigan Ave
Lansing, MI 48912-1896
Phone (517) 364-1000

Other identifiers 1

IdentifierTypeStateIssuer
201293830MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150623000572 IN Practitioner - Obstetrics/Gynecology 5597997528 Reassigns benefits to 1 organization
I20230921003815 MI Practitioner - Obstetrics/Gynecology 5597997528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
Lansing, MI 48912-1894

1215 E Michigan Ave
Lansing, MI 48912-1811

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Sep 1, 2023 Accepting new patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince Dec 6, 2021 Accepting new patients
Healthlinc, Inc CurrentSince Dec 6, 2021 Accepting new patients
Edward W. Sparrow Hospital Association Obstetrics & Gynecology CurrentSince Sep 1, 2023 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

710 Franklin St
Ste 200
Michigan City, IN 46360
Phone (219) 872-6200

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

1200 E Michigan Ave
Ste 325
Lansing, MI 48912
Phone (517) 364-5160

1200 E Michigan Ave
Ste 345
Lansing, MI 48912
Phone (517) 364-5610

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1497053599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121896",
            "telephone_number": "517-364-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDDEBACK",
        "first_name": "ELLEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-14",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "02004563A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101027648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201293830",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.