Viviana Salom Ellis, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

BP10057063 Issued in TX

Practice address

4458 Medical Center Drive
Suite 705
San Antonio, TX 78229

Phone

(210) 614-1000

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

Yes

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 TX

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

Specialty

Obstetrics/Gynecology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unified Womens Healthcare of Texas PLLCGroup PAC ID 4385944230, 180 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.86 of 100Reported as group

Quality

85.25

Promoting interoperability

100

Improvement activities

40

Cost

74.29

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: viviana.ellis.1@11541.direct.athenahealth.com

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.

• Unified Women'S Healthcare of Texas PLLC

  • Obstetrics & Gynecology Physician
  • Addison, TX
  • NPI 1952703373
  Medicare reassignment Care Compare group NPD
• Randall Burt MD PA

  • Specialist
  • Plano, TX
  • NPI 1336279116
  NPD
• Steven R. Macdonald, M.D., P.a.

  • Specialist
  • Plano, TX
  • NPI 1528198397
  NPD
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1124074273
  NPD (past)

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1023463981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL CENTER DRIVE, SUITE 705 SAN ANTONIO, TX 78",
            "address_2": "SUITE 705",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 705",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775550587",
            "country_code": "US",
            "telephone_number": "409-747-4952",
            "fax_number": "409-747-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "VIVIANA",
        "middle_name": "SALOM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "BP10057063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Ellis, PA-C
• Nicole Ellis, LPC
• Rebecca Suzanne Ellis, C.O.T.A.
• Seven Ellis
• Taylor Ellis, FNP-C
• Aishah Destini Ellison
• Erica Ryu Ellsworth, CCP
• Linda Rae Ellsworth, M.D., PH.D.
• Ellysse Canales DDS PC
• Nan Ellzey, LCDC

• Obstetrics & Gynecology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.