MR. WILLARD KEITH CUPP III PMHNP
NPI 1265021406
Nurse Practitioner - Psychiatric/Mental Health in Elkhart, IN
About Mr. Willard Keith Cupp Iii Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. WILLARD KEITH CUPP III PMHNP (NPI 1265021406) is an individual psychiatric/mental health provider in Elkhart, Indiana, licensed in Indiana (71010753A) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Mr. Willard Keith Cupp Iii Pmhnp 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.
Medicare Billing Reassignments
2Medicare enrollment records show Willard Cupp reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Elkhart, IN 46516
- Reassigned Medicare billing, Indiana enrollment
- Medicare enrollment name: Heart City Health Center Inc
- 46 clinicians in this Medicare group
Warsaw, IN 46580
- Reassigned Medicare billing, Indiana enrollment
- 260 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46516 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ELKHART, IN 46516
ELKHART, IN 46516
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 Willard Cupp's NPI number?
The NPI number for Willard Cupp is 1265021406. It was assigned to this individual provider in the NPPES registry on January 12, 2021.
Where is Willard Cupp located?
Willard Cupp practices at 236 Simpson Ave, Elkhart, IN 46516. The listed phone number is (574) 293-0052.
What is Willard Cupp's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Willard Cupp enrolled in Medicare?
Yes. Willard Cupp 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 organizations bill Medicare for Willard Cupp's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Willard Cupp reassigns Medicare benefits to 2 organizations: Healthlinc, Inc (Elkhart, IN) and Bowen Health Inc (Warsaw, IN). Each 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 Willard Cupp's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Willard Cupp accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Willard Cupp 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 Willard Cupp was last updated on November 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mr. Willard Keith Cupp III, PMHNP · NPI 1265021406
Psychiatric/Mental Health physician in Elkhart, Indiana. Individual provider, active in the CMS NPPES registry since January 12, 2021.
## Identity
- **NPI:** 1265021406 (Entity type: Individual)
- **Enumerated:** January 12, 2021
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 71010753A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 236 SIMPSON AVE, Elkhart, IN 46516-4666
- **Phone:** (574) 293-0052
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Healthlinc, Inc (NPI 1720033418, Elkhart, IN); Bowen Health Inc (NPI 1639172810, Warsaw, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** November 3, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1265021406) · Data from the CMS NPPES public registry.