Individual provider Active NPI

Eric D Elliott, MD

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1528058393
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01039357A Issued in IN
Practice address
5901 Technology Center Dr
Indianapolis, IN 46278-6013
Phone
(317) 328-5050
Fax
(317) 715-9965
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01039357A IN Primary

Addresses

Primary practice location

5901 Technology Center Dr
Indianapolis, IN 46278-6013

Mailing address

5901 Technology Center Dr
Indianapolis, IN 46278-6013
Phone (317) 328-5050

Other identifiers 7

IdentifierTypeStateIssuer
069966OtherINHEALTH ALLIANCE-351158723
000000492343OtherINANTHEM 203778927
000545OtherINSIHO-351158723
300100760OtherINRR MEDICARE-351158723
000000082128OtherINANTHEM-351158723
100349120MedicaidIN
Q0070339OtherINCMOSHO351158723&352047427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
68 of 100Reported as group
Quality
80
Improvement activities
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush Memorial Hospital Past Accepting new patients
St. Vincent Health Wellness and Preventive Care Institute, Inc. Past Accepting new patients
St Vincent Northwest Radiology LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1528058393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 TECHNOLOGY CENTER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786013",
            "telephone_number": "317-328-5050",
            "fax_number": "317-715-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 TECHNOLOGY CENTER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786013",
            "telephone_number": "317-328-5050",
            "fax_number": "317-715-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ERIC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01039357A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE-351158723",
            "identifier": "069966",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM 203778927",
            "identifier": "000000492343",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO-351158723",
            "identifier": "000545",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE-351158723",
            "identifier": "300100760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-351158723",
            "identifier": "000000082128",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100349120",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMOSHO351158723&352047427",
            "identifier": "Q0070339",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.