Debbie-Ann Katheen Ellington-Tulloch, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

005626 Issued in CT

Practice address

550 Montauk Hwy
Shirley, NY 11967-2114

Phone

(631) 490-3040

NPI assigned

Jan 6, 2014

Sex

Female

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 NY, OH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Housing Works Health Services III IncGroup PAC ID 7113199852, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: debbieann.ellington.p1@direct.wheelerclinic.nextgenshare.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.

• Housing Works Health Services III, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1114950151
  Medicare reassignment Care Compare group NPD
• Boulder Care Provider Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  OH

  Medicare reassignment Care Compare group
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Lancaster Wellness NP in Adult Health PLLC

  • Adult Health Nurse Practitioner
  • Farmingdale, NY
  • NPI 1043151160
  NPD Authorized official
• Housing Works Health Services III, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1750934436
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• Absolute Outcomes, LLC

  • Internal Medicine Physician
  • Monroe, CT
  • NPI 1073746202
  NPD (past)

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1083036313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672114",
            "telephone_number": "631-490-3040",
            "fax_number": "631-490-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672114",
            "telephone_number": "631-490-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Northwestern Dr",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "CT",
            "postal_code": "06062",
            "country_code": "US",
            "telephone_number": "888-793-3500",
            "fax_number": "860-793-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGTON-TULLOCH",
        "first_name": "DEBBIE-ANN",
        "middle_name": "KATHEEN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "005626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Randall Dynof, MD
• Eastern Island Medical Care PC
• Kimberly Edwards
• Tracy L Egger, LCSW
• Noha Aladdin Elfar, OTR/L
• Ebenezer Enin, RN
• Deborah Esposito, LPN
• Facesofexoticism
• Lisa Failla
• Marianne T Fassino, RN

• Adult Health Nurse Practitioner in Shirley, NY
• Providers in Shirley, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.