Samuel Christopher Ellis-Stockley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008376 Issued in MI

Practice address

28300 Orchard Lake Rd Ste 200
Farmington Hills, MI 48334-3704

Phone

(248) 539-8630

Fax

(248) 539-9045

NPI assigned

Sep 7, 2017

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
• Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as group

Quality

64.16

Promoting interoperability

100

Improvement activities

40

Cost

73.79

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: samuel.ellis-stockley.1@9704.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.

• VHS Physicians of Michigan

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment Care Compare group
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• VHS Huron Valley-Sinai Hospital Inc

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation
• VHS Rehabilitation Institute of Michigan Inc

  • Rehabilitation Hospital
  • Detroit, MI
  • NPI 1871805150

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1023536364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30986 STONE RIDGE DR APT 14201",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483933891",
            "telephone_number": "734-308-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28300 ORCHARD LAKE RD STE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343704",
            "telephone_number": "248-539-8630",
            "fax_number": "248-539-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-STOCKLEY",
        "first_name": "SAMUEL",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tearnie Elliott
• Tiffany Elliott
• Torrie Elliott
• Whitney Elliott
• Nubia Ellis-Kemp
• Aaron Ellis
• Alexis Ellis
• Alyssa Ellis
• Andrea Ellis
• Azia Ellis

• Physician Assistant in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.