Lauren Ellis

Individual provider Active NPI Adult Health Nurse Practitioner · Lima, PA

NPI 1043661325 · NPPES record last updated Jun 28, 2016

Key facts

NPI
1043661325
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
SP016231 (PA)
Practice address
340 N Middletown Rd
Lima, PA 19037
Phone
(610) 891-5840
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Merit-based Incentive Payment System (MIPS)

Final score
19.87 of 100 (individual)
Quality
0
Improvement activities
0
Cost
66.24

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160818000043 PA Practitioner - Nurse Practitioner 1052606852

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP016231PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Gerontology Associates LLP Current
since Jul 16, 2016
Accepting new patients

Locations

340 N Middletown Rd
Media, PA 19063
Phone (610) 565-7810

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP016231 PA Yes

Addresses

Primary practice location

340 N Middletown Rd
Lima, PA 19037

Mailing address

1098 W Baltimore Pike
Media, PA 19063-5139

Other providers in Lima, PA

All providers in Lima, PA · Adult Health Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.