Active NPI
Robin Kahn Ellis, N.P.
- Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1124203781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 19340
- Practice address
- 1200 N State St
Los Angeles, CA 90033-1029 - Phone
- (213) 713-1780
- NPI assigned
- Jan 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 19340 | CA | Primary |
Addresses
Primary practice location
1200 N State St
Los Angeles, CA 90033-1029
Mailing address
1357 1/2 Laveta Ter
Los Angeles, CA 90026-3321
Phone (213) 713-1780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251003000403 | NY | Order and Referring Only - Nurse Practitioner | 6305213398 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262563200000",
"number": "1124203781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1357 1/2 LAVETA TER",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900263321",
"telephone_number": "213-713-1780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "213-713-1780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "ROBIN",
"middle_name": "KAHN",
"credential": "N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-02",
"last_updated": "2010-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "19340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.