Individual provider Active NPI

W Alexander Ellis

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1083075303
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A140782 Issued in CA
Practice address
7601 Hospital Dr
103
Sacramento, CA 95823-5408
Phone
(916) 681-1600
NPI assigned
Mar 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A140782 CA Primary

Addresses

Primary practice location

7601 Hospital Dr
103
Sacramento, CA 95823-5408

Mailing address

1334 N Cherokee Ave
Los Angeles, CA 90028-7702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20180524001004 CA Practitioner - Family Practice 1456616366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

2110 E El Segundo Blvd
El Segundo, CA 90245-4502

2900 Lomita Blvd
Torrance, CA 90505-5102
Phone (310) 257-7260

514 N Prospect Ave
FL 4
Redondo Beach, CA 90277-3040
Phone (310) 750-3300

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A140782CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc Family Medicine CurrentSince Jul 9, 2018 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

2110 E El Segundo Blvd
Ste 230
El Segundo, CA 90245
Phone (310) 257-5741

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

3640 Lomita Blvd
Ste 200
Torrance, CA 90505
Phone (310) 378-7070

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1083075303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 N CHEROKEE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 HOSPITAL DR",
            "address_2": "103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235408",
            "telephone_number": "916-681-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "W ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A140782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.