Individual provider Active NPI

John Masou Ellison, M.D.

  • Emergency Medicine Physician
  • Monterey, CA
National Provider Identifier
1093845943
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G79299 Issued in CA
Practice address
23625 WR Holman Highway
Monterey, CA 93940
Phone
(831) 624-5311
Fax
(831) 625-4948
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G79299 CA Primary

Addresses

Primary practice location

23625 WR Holman Highway
Monterey, CA 93940

Mailing address

PO Box HH
Business Development Department
Monterey, CA 93940
Phone (831) 622-2716

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
I20081013000323 CA Practitioner - Emergency Medicine 2466434766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Diego School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monterey Bay Observation MedicineGroup PAC ID 1052630514, 32 clinicians

Practice addresses (Care Compare)

23625 Holman Hwy
Monterey, CA 93940-5902
Phone (831) 625-4900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as individual
Quality
97.98
Improvement activities
0
Cost
82.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79299CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Peninsula Urgent Care Medical Group Inc Current Accepting new patients
Monterey Bay Observation Medicine Emergency Medicine CurrentSince Feb 17, 2015 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 1, 2012 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 1, 2012 Accepting new patients
Monterey Bay Emergency Physicians Medical Corporation Emergency Medicine PastSince Feb 7, 2010 Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

Organizations & group practices 5

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 2

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093845943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX HH",
            "address_2": "BUSINESS DEVELOPMENT DEPARTMENT",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93940",
            "telephone_number": "831-622-2716",
            "fax_number": "831-625-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23625 WR HOLMAN HIGHWAY",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93940",
            "telephone_number": "831-624-5311",
            "fax_number": "831-625-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JOHN",
        "middle_name": "MASOU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G79299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.