DR. EDITH M CULLEN M.D.
NPI 1720073521
Family Medicine - Sports Medicine in Elkhart, IN

Active since September 19, 2005PECOS EnrolledAccepts Medicare Assignment
78.32/100
CMS Quality Rating
2310 CALIFORNIA RD, ELKHART, IN 46514(574) 264-4163(574) 262-9650 Get Directions Write a Review

NPPES record last updated: October 23, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Edith M Cullen M.d. NPPES

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

DR. EDITH M CULLEN M.D. (NPI 1720073521) is an individual sports medicine provider in Elkhart, Indiana, licensed in Indiana (01061215A) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Elkhart General Hospital, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2004).

NPPES Registry Identity

NPI1720073521
Entity TypeIndividualFemale
Primary Taxonomy207QS0010X
Provider Legal NameDR. EDITH M CULLENCredential: M.D.
Location Address2310 CALIFORNIA RDElkhart, IN 46514-1228
Mailing Address2310 California RdElkhart, IN 46514-1228 · (574) 264-4163 · Fax (574) 262-9650
Fax(574) 262-9650
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2004
Enumeration DateSeptember 19, 2005
Last NPPES UpdateOctober 23, 2013
NPI 1720073521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License Licensed in IN · 01061215A
Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 01061215A (IN)
2310 CALIFORNIA RD, Elkhart, IN 46514

Other Identifiers 3

Medicare UPINOTH000IL
Medicaid201092890IN
Medicare PIN223420004IN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Edith M Cullen M.d. 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 ID2668610734
PECOS Enrollment IDI20130906000696
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.

Areas of Expertise CMS Part B claims 30

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.

Injection, romosozumab-aqqg, 1 mg J3111
Romosozumab-aqqg is a medication given by injection to treat osteoporosis in patients at high risk for fractures. It works by increasing bone mass and strength, reducing the risk of fractures.
23,100 services21 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
9,783 services93 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
1,438 services243 patients
Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
379 services285 patients
Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
314 services247 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
275 services113 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Elkhart General Hospital

Acute Care Hospitals · Elkhart, IN
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number150018
Location600 E BlvdElkhart, IN 46514 · Elkhart County
Emergency services Birthing friendly

Goshen Hospital

Acute Care Hospitals · Goshen, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150026
Location200 High Park AveGoshen, IN 46526 · Elkhart County
Emergency services Birthing friendly

Kosciusko Community Hospital

Acute Care Hospitals · Warsaw, IN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number150133
Location2101 E Dubois DrWarsaw, IN 46580 · Kosciusko County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46514 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.05
Promoting Interoperability90
Improvement Activities40
Cost78.03

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
38%32 patients2/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
57%659 patients3/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%2,815 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%741 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
100%477 patients5/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
92%1,123 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
87%1,867 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
54%477 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
79%1,424 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
38%525 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 69% · 967 patients
Patients tobacco: 99% · 75 patients
68%967 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
85%1,867 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
7%1,867 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 477 patients
1%477 patients4/55-star benchmark: 100%
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 16% · 204 patients
Patients physicalActivity: 14% · 204 patients
96%204 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Physical Therapist
2310 CALIFORNIA RD, SUITE A
ELKHART, IN 46514
Physical Therapist
2310 CALIFORNIA RD, SUITE A
ELKHART, IN 46514
Occupational Therapist
2310 CALIFORNIA RD, SUITE A
ELKHART, IN 46514
Physical Therapist
2310 CALIFORNIA RD, SUITE A
ELKHART, IN 46514
Podiatrist
2310 CALIFORNIA RD
ELKHART, IN 46514
Specialist/Technologist (Athletic Trainer)
2310 CALIFORNIA RD
ELKHART, IN 46514
Specialist/Technologist (Athletic Trainer)
2310 CALIFORNIA RD
ELKHART, IN 46514
Nurse Anesthetist, Certified Registered
2310 CALIFORNIA RD, STE A
ELKHART, IN 46514

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 Edith Cullen's NPI number?

The NPI number for Edith Cullen is 1720073521. It was assigned to this individual provider in the NPPES registry on September 19, 2005.

Where is Edith Cullen located?

Edith Cullen practices at 2310 California Rd, Elkhart, IN 46514. The listed phone number is (574) 264-4163.

What is Edith Cullen's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Edith Cullen enrolled in Medicare?

Yes. Edith Cullen 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.

What insurance does Edith Cullen accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Edith Cullen 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.

Is Edith Cullen affiliated with any hospitals?

According to CMS data, Edith Cullen is affiliated with Elkhart General Hospital, Goshen Hospital and Kosciusko Community Hospital.

When was this NPI record last updated?

The NPPES record for Edith Cullen was last updated on October 23, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.