George Frederick Ellis, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

163161 Issued in NY

Practice address

89 W Copeland Dr
Orlando, FL 32806-2002

Phone

(321) 842-6910

Fax

(321) 843-5998

NPI assigned

Jul 12, 2006

Last updated

Oct 25, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577

  Urology

  Medicare reassignment NPD
• George F. Ellis, MD, Incorporated

  • Urology Physician
  • Winter Park, FL
  • NPI 1760436844
  NPD (past) Authorized official
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD
• Orlando Health Network Inc

  • Psychiatry Physician
  • Longwood, FL
  • NPI 1548295199
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1033144597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD",
            "address_2": "FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 W COPELAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062002",
            "telephone_number": "321-842-6910",
            "fax_number": "321-843-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "GEORGE",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "163161",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME49437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273075800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME49437",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellis H. Schauder DC (Schauder Chiropractic Care)
• Colton Ellis
• Denise Ellis, AGAC-NP-BC
• Elizabeth Gilbert Ellis
• Emily Ellis, PA
• Keisha Ellis, NP
• Kendra Ellis, PHARMD
• Lashanda Ellis, MSW
• Maleeka Monique Ellis, RRT
• Rachel Lynn Annette Ellis, PHYSICAL THERAPIST

• Urology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.