Active NPI
John Ellie, M.D.
- Anesthesiology Physician
- Williamsville, NY
National Provider Identifier
1023026069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 142491-1
- Practice address
- 338 Harris Hill Rd
Suite 207
Williamsville, NY 14221-7470 - Phone
- (716) 634-4798
- Fax
- (716) 634-0987
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 142491-1 | NY | Primary |
Addresses
Primary practice location
338 Harris Hill Rd
Suite 207
Williamsville, NY 14221-7470
Mailing address
338 Harris Hill Rd
Suite 207
Williamsville, NY 14221-7470
Phone (716) 634-4798
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00808080 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142491-1 | NY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates for Women'S Medicine PLLC | Current | Accepting new patients | |
| Parkside Medical Anesthesia Associates | Anesthesiology | Past | Accepting new patients |
| Upstate Anesthesia Services, P.C. | Anesthesiology | Past | Accepting new patients |
| Anesthesia Associates of Rochester, P.C. | Anesthesiology | Past | Accepting new patients |
| Troy Infectious Disease and Primary Care LLC | Past | Accepting new patients |
Locations
4302 Medical Center Dr
Ste 302
Fayetteville, NY 13066
Phone (315) 423-9722
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 5
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.
-
- Obstetrics & Gynecology Physician
- Syracuse, NY
- NPI 1942258702
-
- Anesthesiology Physician
- Rochester, NY
- NPI 1760421788
-
- Anesthesiology Physician
- Buffalo, NY
- NPI 1871537464
-
- Infectious Disease Physician
- Troy, NY
- NPI 1952609125
-
- Anesthesiology Physician
- East Meadow, NY
- NPI 1629272141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1023026069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 HARRIS HILL RD",
"address_2": "SUITE 207",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142217470",
"telephone_number": "716-634-4798",
"fax_number": "716-634-0987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "338 HARRIS HILL RD",
"address_2": "SUITE 207",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142217470",
"telephone_number": "716-634-4798",
"fax_number": "716-634-0987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIE",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "142491-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00808080",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.