Mary Kristine Ellis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

277569 Issued in NY

Practice address

196 Merrick Rd
Oceanside, NY 11572-1420

Phone

(516) 255-8400

NPI assigned

May 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: maryellis@snch.allscriptsdirect.net

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.

• Mount Sinai School of Medicine

  dba Mount Sinai Marathon Medical

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1508127531
  Medicare reassignment Care Compare group NPD
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty practice Group

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment NPD
• NYU Langone Hospitals

  • Internal Medicine Physician
  • New York, NY
  • NPI 1790975944
  Medicare reassignment NPD
• Wyckoff Professional Medical Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1659710796
  Medicare reassignment NPD
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1730491945
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1740913763
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Emergency Medicine Physician
  • Elmhurst, NY
  • NPI 1770837742
  NPD
• Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1508333956
  NPD
• NYU Langone Hospitals

  dba NYU Langone Hospital - Suffolk

  • Psychiatric Hospital Unit
  • Patchogue, NY
  • NPI 1508687021
  NPD
• NYU Langone Hospitals

  dba NYU Lutheran Family Health Center Quality Care Group

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1831549559
  NPD

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

• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  Care Compare affiliation

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1134447329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-255-8400",
            "fax_number": "516-255-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721420",
            "telephone_number": "516-255-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503917",
            "country_code": "US",
            "telephone_number": "516-497-7520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARY",
        "middle_name": "KRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116438",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "277569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Enlz Inc

• Family Medicine Physician in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.