NPIMap

Individual provider Active NPI

Ellis Mez, M.D.

  • Internal Medicine Physician
  • Eldersburg, MD
National Provider Identifier
1023029956
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D22220 Issued in MD
Practice address
1645 Liberty Rd
Suite 204
Eldersburg, MD 21784-6521
Phone
(410) 795-7737
Fax
(410) 795-2828
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D22220 MD Primary

Addresses

Primary practice location

1645 Liberty Rd
Suite 204
Eldersburg, MD 21784-6521

Mailing address

1645 Liberty Rd
Suite 204
Eldersburg, MD 21784-6521
Phone (410) 795-7737

Other identifiers 2

IdentifierTypeStateIssuer
245377YEVBOtherMDMEDICARE ID
328231700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000509 MD Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8527198290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Maryland School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Lifebridge Primary Care of Eldersburg LLCGroup PAC ID 0345465654, 5 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

1645 Liberty Rd
Suite 204
Sykesville, MD 21784-6542
Phone (410) 795-7737

Hospital & facility affiliations

  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Amedisys Home Health Home health agency, Westminster, MD, CCN 217048

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
86.91
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D34849MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc CurrentSince Jul 11, 2012 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jul 11, 2012 Accepting new patients
Lifebridge Primary Care of Eldersburg, LLC Internal Medicine CurrentSince May 1, 2014 Accepting new patients
Integrace Health Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7200 Third Ave
Ste 1000
Sykesville, MD 21784
Phone (410) 795-8800

1645 Liberty Rd
Ste 204
Sykesville, MD 21784
Phone (410) 795-7737

7200 Third Ave
Sykesville, MD 21784
Phone (410) 795-8800

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 6

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 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1023029956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LIBERTY RD",
            "address_2": "SUITE 204",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846521",
            "telephone_number": "410-795-7737",
            "fax_number": "410-795-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LIBERTY RD",
            "address_2": "SUITE 204",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846521",
            "telephone_number": "410-795-7737",
            "fax_number": "410-795-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZ",
        "first_name": "ELLIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D22220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "245377YEVB",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328231700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

Verify at the official NPI Registry.