David Yehuda Ellenberg, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

4301094251 Issued in MI

Practice address

33400 6 Mile Rd
Livonia, MI 48152-3143

Phone

(734) 421-2020

NPI assigned

Nov 3, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Wayne State University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Ophthalmology Specialists PLLCGroup PAC ID 3577557131, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dellenberg412897@direct.hfhs.org
• Direct secure messaging: dellenberg1126145@direct.hfhs.org

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.

• Michigan Ophthalmology Specialists, PLLC

  dba Advanced Ophthalmology Associates

  • Ophthalmology Physician
  • Livonia, MI
  • NPI 1942272364
  Medicare reassignment Care Compare group NPD
• VMD Primary Providers Eastern Michigan, PC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1336625540
  Medicare reassignment NPD
• Michigan Ophthalmology Specialists, PLLC

  • Ophthalmology Physician
  • Troy, MI
  • NPI 1871367466
  Authorized official Same address or phone
• Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
  • NPI 1578891750
  NPD
• Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
  • NPI 1821391848
  NPD
• Michigan Ophthalmology Specialists, PLLC

  • Ophthalmology Physician
  • Northville, MI
  • NPI 1699486191
  NPD
• Sinai Hospital of Baltimore Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1437174059

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1063749604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30150 TELEGRAPH RD STE 271",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254521",
            "telephone_number": "248-395-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33400 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523143",
            "telephone_number": "734-421-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24241 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481241801",
            "country_code": "US",
            "telephone_number": "313-561-7255",
            "fax_number": "313-561-6137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "DAVID",
        "middle_name": "YEHUDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301094251",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MI",
            "license": "4301094251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dellenberg@osm.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "33400 6 Mile Rd",
            "city": "Livonia",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481523143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jane Ashley Elias, NP
• Nilo Salavarria Elizalde, MSN, PMHNP-BC
• Collin Elkins, DPT
• Billie Elledge
• Hallee Ellefson
• David R Ellis, D.C
• Kayla Carignan Ellis, BEHAVIOR TECHNICIAN
• Lakia Ellis, MA, LPC
• Mya Ellison
• Naomi Ellison

• Retina Specialist (Ophthalmology) Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Retina Specialist (Ophthalmology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.