Ellis John Civello Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G7046 Issued in TX

Practice address

230 Mesa Verde Dr E
Center Point, TX 78010-3548

Phone

(830) 460-6655

NPI assigned

Oct 3, 2006

Last updated

Dec 15, 2025By 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 1

Addresses

Other identifiers 1

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

Psychiatry

Education

University of Texas Medical School at San Antonio, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Andala Medical Texas PAGroup PAC ID 7416330436, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Andala Medical Texas PA

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1386224137
  Medicare reassignment Care Compare group
• Department of State Health Services

  dba Texas Center for Infectious Disease

  • Clinic/Center
  • San Antonio, TX
  • NPI 1316000144
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1063507432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MESA VERDE DR E",
            "city": "CENTER POINT",
            "state": "TX",
            "postal_code": "780103548",
            "telephone_number": "830-634-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MESA VERDE DR E",
            "city": "CENTER POINT",
            "state": "TX",
            "postal_code": "780103548",
            "telephone_number": "830-460-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVELLO",
        "first_name": "ELLIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G7046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139933924",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center Point Isd
• Center Point Isd
• Children's Association for Maximum Potential
• Bryan Mark Davis, D.O.
• Veronica Adame Knotts, CRT
• Karen Nunnery
• Maria Jeanette Ramirez
• Rosalva Sanchez

• Psychiatry Physician in Center Point, TX
• Providers in Center Point, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.