Active NPI
Edith M Cullen, M.D.
- Sports Medicine (Family Medicine) Physician
- Elkhart, IN
National Provider Identifier
1720073521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 01061215A
- Practice address
- 2310 California Rd
Elkhart, IN 46514-1228 - Phone
- (574) 264-4163
- Fax
- (574) 262-9650
- NPI assigned
- Sep 19, 2005
- Last updated
- Jul 28, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 01061215A | IN | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 01061215A | IN | Primary |
Addresses
Primary practice location
2310 California Rd
Elkhart, IN 46514-1228
Mailing address
2310 California Rd Ste a
Elkhart, IN 46514-1228
Phone (574) 264-0791
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Texas Tech University Health Science Center School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1775 E Kercher Rd
Orthopedic and Sports Medicine Center
Goshen, IN 46526-6308
Phone (574) 533-0300
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.85 of 100
- Quality
- 59.71
- Promoting interoperability
- 90
- Improvement activities
- 40
- Cost
- 88.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01061215A | IN | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ASC Surgical Ventures, LLC | Past | Accepting new patients |
Interoperability endpoints
- edith.cullen@direct.osmc.nextgenshare.com
Organizations & group practices 2
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.
-
dba Osmc
- Orthopaedic Surgery Physician
- Elkhart, IN
- NPI 1710085253
-
dba OSMC Outpatient Surgery Center
- Ambulatory Surgical Clinic/Center
- Elkhart, IN
- NPI 1083715148
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
dba Parkview Goshen Hospital
- General Acute Care Hospital
- Goshen, IN
- NPI 1740268846
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
dba Memorial Epworth Center
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
dba Beacon Granger Hospital, A Memorial Hospital Extension
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
dba Greencroft Healthcare
- Skilled Nursing Facility
- Goshen, IN
- NPI 1770586554
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1720073521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 CALIFORNIA RD STE A",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141228",
"telephone_number": "574-264-0791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 CALIFORNIA RD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141228",
"telephone_number": "574-264-4163",
"fax_number": "574-262-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLEN",
"first_name": "EDITH",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-19",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IN",
"license": "01061215A",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "IN",
"license": "01061215A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.