Jeffrey M Ellenbogen, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

226436 Issued in MA

Practice address

55 Fruit Street
Wang 720 (Neurology)
Boston, MA 02114

Phone

(617) 724-7419

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sinai Hospital of Baltimore Inc

  • Surgical Critical Care Physician
  • Baltimore, MD
  • NPI 1043235666
  Medicare reassignment NPD
• Sinai Hospital of Baltimore Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1669497285
  NPD
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1003856535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WHITE OAK RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024681323",
            "telephone_number": "617-724-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "WANG 720 (NEUROLOGY)",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-724-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "226436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burak Elkiran, M.D
• Jacob Matt Elkon, MD
• Hatem Abdallah Ellaithy, MD
• Kristen K. Ellard, MA
• Jacob Ellen
• Max Ellenhorn
• Todd B Ellerin, M.D.
• Samuel A Ellias, M.D.
• Ashley Elliman, RN, NP-C
• Rachel Ellingson, MSW, LICSW

• Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.