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ELLEN HEREDIA CNP
NPI 1740635762
Nurse Practitioner - Gerontology in Cincinnati, OH

Active since April 27, 2016PECOS EnrolledAccepts Medicare Assignment
78.78/100
CMS Quality Rating
234 GOODMAN ST, CINCINNATI, OH 45219(513) 558-4194 Get Directions Write a Review

NPPES record last updated: May 31, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ellen Heredia Cnp NPPES

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

ELLEN HEREDIA CNP (NPI 1740635762) is an individual gerontology provider in Cincinnati, Ohio, licensed in Ohio (CNP 019536) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with University Of Cincinnati Medical Center, Llc, and is a graduate of University Of Cincinnati College Of Medicine (2016).

NPPES Registry Identity

NPI1740635762
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameELLEN HEREDIACredential: CNP
Location Address234 GOODMAN STCincinnati, OH 45219-2364
Mailing AddressPo Box 636256, Central CredentialingCincinnati, OH 45263-6256 · (513) 585-5502 · Fax (513) 585-5511
Phone(513) 558-4194
Sole ProprietorYes
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2016
Enumeration DateApril 27, 2016
Last NPPES UpdateMay 31, 2017
✔ NPI 1740635762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in OH · CNP 019536
234 GOODMAN ST, Cincinnati, OH 45219
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Oscar Health Insurance.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

Ellen Heredia Cnp 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 ID8729372644
PECOS Enrollment IDI20160815002531
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 3

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
56 services55 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
36 services27 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

University Of Cincinnati Medical Center, LLC

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360003
Location3188 Bellevue AvenueCincinnati, OH 45219 · Hamilton County
Emergency services Birthing friendly

West Chester Hospital

Acute Care Hospitals · West Chester, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360354
Location7700 University DriveWest Chester, OH 45069 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

78.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.42
Promoting Interoperability100
Improvement Activities40
Cost58.86

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.

ALEXANDER TOPALA MD
Anesthesiology
234 GOODMAN ST, MAIL LOCATION 0796
CINCINNATI, OH 45219
Hamilton County (513) 584-1000
MELISSA T WESLEY CRNA
Nurse Anesthetist, Certified Registered
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-4194
DR. SAURABH CHANDRA MD
Internal Medicine (Critical Care Medicine)
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-1000
JOSEPH D PANDISCIA PA-C
Physician Assistant
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 475-8690
RACHEL BEAUPRE
Student in an Organized Health Care Education/Training Program
234 GOODMAN ST, THORACIC SURGERY
CINCINNATI, OH 45219
Hamilton County (513) 584-1387
KATIE DEAN
Nurse Anesthetist, Certified Registered
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-4194
MICHELLE CHAPMAN
Anesthesiology
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-6356
KAYLA BERTKE
Pharmacist
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 584-3468

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 Ellen Heredia's NPI number?

The NPI number for Ellen Heredia is 1740635762. It was assigned to this individual provider in the NPPES registry on April 27, 2016.

Where is Ellen Heredia located?

Ellen Heredia practices at 234 Goodman St, Cincinnati, OH 45219. The listed phone number is (513) 558-4194.

What is Ellen Heredia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Ellen Heredia enrolled in Medicare?

Yes. Ellen Heredia 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 Ellen Heredia accept?

Health plans from CareSource, MedMutual and Oscar Health Insurance list Ellen Heredia 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 Ellen Heredia affiliated with any hospitals?

According to CMS data, Ellen Heredia is affiliated with University Of Cincinnati Medical Center, LLC and West Chester Hospital.

When was this NPI record last updated?

The NPPES record for Ellen Heredia was last updated on May 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.