NPIMap

Individual provider Active NPI

Brennan Ellis, M.D.

  • Emergency Medicine Physician
  • Syracuse, NY
National Provider Identifier
1003019514
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
256992 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2342
Phone
(315) 464-6202
Fax
(315) 464-9501
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 256992 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2342

Mailing address

750 E Adams St
Syracuse, NY 13210-2342
Phone (315) 464-6202

Other identifiers 2

IdentifierTypeStateIssuer
P00890823OtherNYRAILROAD MEDICARE
03248175MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150515001728 MD Practitioner - Emergency Medicine 4688866296 Reassigns benefits to 3 organizations
I20240705000879 CO Practitioner - Emergency Medicine 4688866296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carepoint Emergency Medicine, PLLCGroup PAC ID 7810291432, 160 clinicians

Practice addresses (Care Compare)

14200 E Arapahoe Rd
Centennial Medical Plaza
Englewood, CO 80112-4065
Phone (303) 699-3060

Hospital & facility affiliations

  • The Medical Center of Aurora & South Hospital Hospital, Aurora, CO, CCN 060100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carepoint Emergency Medicine, PLLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Emergency Medicine Associates, PA Emergency Medicine CurrentSince May 15, 2024 Accepting new patients
Chester River Hospital Center Emergency Medicine CurrentSince Mar 1, 2015 Accepting new patients
Chester River Hospital Center Current Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 15, 2024 Accepting new patients
Upper Chesapeake Emergency Medicine Physicians, LLC Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients
Chester River Health Center CurrentSince Mar 1, 2015 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine Current Accepting new patients

Locations

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

14200 E Arapahoe Rd
Englewood, CO 80112
Phone (303) 699-3000

660 McHenry Rd
Aberdeen, MD 21001
Phone (443) 643-1500

520 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (410) 836-0128

300 Byrn St
Cambridge, MD 21613
Phone (410) 228-5511

100 Brown St
Chestertown, MD 21620
Phone (410) 778-3300

219 S Washington St
Easton, MD 21601

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Interoperability endpoints

  • FHIR API: https://fhir.umm.edu/fhir/api/FHIR/R4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1003019514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-6202",
            "fax_number": "315-464-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-464-6202",
            "fax_number": "315-464-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "BRENNAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "256992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00890823",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03248175",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.