NPIMap

Individual provider Active NPI

Diane M Pfeifer, MD

  • Specialist
  • Kokomo, IN
National Provider Identifier
1730183450
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01050142 Issued in IN
Practice address
2350 S Dixon Rd
Ste 400
Kokomo, IN 46902-6420
Phone
(765) 455-9801
Fax
(765) 455-9840
NPI assigned
Jun 10, 2005
Last updated
Mar 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01050142 IN Primary

Addresses

Primary practice location

2350 S Dixon Rd
Ste 400
Kokomo, IN 46902-6420

Mailing address

2350 S Dixon Rd
Ste 400
Kokomo, IN 46902-6420
Phone (765) 455-9801

Other identifiers 2

IdentifierTypeStateIssuer
2002234890AMedicaidIN
000000093486OtherINBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000064 IN Practitioner - Internal Medicine 0446287379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

804 S Berkley Rd
Pfeifer Internal Medicine
Kokomo, IN 46901-5198
Phone (765) 455-9801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.67 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01050142INMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pfeifer Internal Medicine, PC CurrentSince Feb 15, 2014 Accepting new patients
Major Hospital Past Accepting new patients
Internal Medicine Associates of Kokomo Specialist Past Accepting new patients

Locations

136 N Dixon Rd
Kokomo, IN 46901
Phone (765) 455-9801

2226 W Alto Rd
Kokomo, IN 46902
Phone (765) 453-7701

804 S Berkley Rd
Kokomo, IN 46901
Phone (765) 455-9801

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

Hospital & facility affiliations 11

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1730183450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 S DIXON RD",
            "address_2": "STE 400",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026420",
            "telephone_number": "765-455-9801",
            "fax_number": "765-455-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S DIXON RD",
            "address_2": "STE 400",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026420",
            "telephone_number": "765-455-9801",
            "fax_number": "765-455-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01050142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002234890A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000093486",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.