Patrick B. Ilada, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01054010A Issued in IN

Practice address

1000 Provident Dr Ste C
Warsaw, IN 46580-3255

Phone

(574) 267-8728

Fax

(574) 269-3470

NPI assigned

Jun 1, 2006

Last updated

Oct 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

General Surgery

Education

Indiana University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kosciusko Medical Group LLCGroup PAC ID 5496809956, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kosciusko Medical Group LLC

  • Family Medicine Physician
  • Warsaw, IN
  • NPI 1932349594

  Surgery

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Warsaw Health System LLC

  dba Lutheran Kosciusko Hospital

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1508803081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3513",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PROVIDENT DR STE C",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803255",
            "telephone_number": "574-267-8728",
            "fax_number": "574-269-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILADA",
        "first_name": "PATRICK",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01054010A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200326000",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.ilada@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1000 Provident Dr Ste C",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Human Wellness Collective LLC
• Amber Trevae Hunt, HHA
• Ashley Erin Hunter, M.A.
• Ha Kang Hwang
• Jessica A Iden, COTA
• Nilanka Rurangi Silva Inasi, MA
• Indiana Physical Therapy, Inc.
• Dominique Islas
• Jace Medical LLC
• Elizabeth Ann Jackson, COTA

• Surgery Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.