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KELLY S EARNST PH.D, HSPP
NPI 1104900489
Clinical Neuropsychologist in Lafayette, IN

Active since October 24, 2006PECOS EnrolledAccepts Medicare Assignment
1415 SALEM ST, SUITE 102, LAFAYETTE, IN 47904(765) 742-1816(765) 742-2557 Get Directions Write a Review

NPPES record last updated: June 27, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly S Earnst Ph.d, Hspp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY S EARNST PH.D, HSPP (NPI 1104900489) is an individual clinical neuropsychologist in Lafayette, Indiana, licensed in (20041614A) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Vanderbilt University School Of Medicine (1998).

NPPES Registry Identity

NPI1104900489
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameKELLY S EARNSTCredential: PH.D, HSPP
Location Address1415 SALEM ST, SUITE 102Lafayette, IN 47904-4100
Mailing Address202 Myers RdDanville, IN 46122-9702 · (317) 718-8436 · Fax (317) 718-8438
Phone(765) 742-1816
Fax(765) 742-2557
Sole ProprietorNo
Medical School CMSVanderbilt University School Of MedicineGraduated 1998
Enumeration DateOctober 24, 2006
Last NPPES UpdateJune 27, 2022
NPPES CertifiedJune 27, 2022
✔ NPI 1104900489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed · 20041614A
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
1415 SALEM ST, Lafayette, IN 47904
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Other Identifiers 1

Medicaid200283610AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly S Earnst Ph.d, Hspp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012182819
PECOS Enrollment IDI20111206000471
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Earnst reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Modern Mental Health, Inc.
3.8 mi
Clinical
1330 WIN HENTSCHEL BLVD
West Lafayette, IN 47906
  • Reassigned Medicare billing, Indiana enrollment
NPI 1740741750 (765) 444-3999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes 96139
This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.
142 services33 patients
Evaluation of neuropsychological test, each additional hour 96133
This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.
66 services33 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
64 services33 patients
Administration of psychological or neuropsychological test by technician, first 30 minutes 96138
This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.
33 services33 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
32 services32 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRANCISCAN ST. ELIZABETH HEALTH
Hospice Care, Community Based
1415 SALEM ST, SUITE 202W
LAFAYETTE, IN 47904
Tippecanoe County (765) 423-6224
JILL E SALEM PH.D., HSPP
Clinical Neuropsychologist
1415 SALEM ST, SUITE 102
LAFAYETTE, IN 47904
Tippecanoe County (765) 742-1816
MRS. DIANE FARKAS R.PH.
Pharmacist
1415 SALEM ST, SUITE B9
LAFAYETTE, IN 47904
Tippecanoe County (765) 423-6358
FRANCISCAN ST. ELIZABETH HEALTH
Home Health
1415 SALEM ST, SUITE 202W
LAFAYETTE, IN 47904
Tippecanoe County (765) 449-5046
GAYLE Y IWAMASA PH.D., HSPP
Psychologist (Clinical)
1415 SALEM ST, SUITE 102
LAFAYETTE, IN 47904
Tippecanoe County (765) 742-1816

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Earnst's NPI number?

The NPI number for Kelly Earnst is 1104900489. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Where is Kelly Earnst located?

Kelly Earnst practices at 1415 Salem St Suite 102, Lafayette, IN 47904. The listed phone number is (765) 742-1816.

What is Kelly Earnst's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Kelly Earnst enrolled in Medicare?

Yes. Kelly Earnst is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kelly Earnst's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Earnst reassigns Medicare benefits to Modern Mental Health, Inc. (West Lafayette, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Earnst's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Earnst accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Kelly Earnst as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Earnst was last updated on June 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.