Individual provider Active NPI

Sarah Ellis

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1093582280
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016461 Issued in GA
Practice address
801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone
(866) 991-0900
NPI assigned
Dec 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016461 GA Primary

Addresses

Primary practice location

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224

Mailing address

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone (866) 991-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402002972 WA Practitioner - Physical Therapist in Private Practice 0547608184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lopez Island Physical Therapy LLCGroup PAC ID 2062772072, 2 clinicians

Practice addresses (Care Compare)

192 Lopez Rd
Lopez Island, WA 98261-8290
Phone (360) 468-4382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016461GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lopez Island Physical Therapy LLC Physical Therapist CurrentSince Apr 21, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1093582280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.