Individual provider Active NPI

Ellen Ouellette, MD

  • Family Medicine Physician
  • Ganado, AZ
National Provider Identifier
1144719048
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
79194 Issued in AZ
Practice address
Cedar Hills Road & Az 264
Ganado, AZ 86505
Phone
(928) 755-4500
Fax
(928) 755-4659
NPI assigned
May 7, 2018
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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 79194 AZ Primary

Addresses

Primary practice location

Cedar Hills Road & Az 264
Ganado, AZ 86505

Mailing address

US 191 and Az 264
Ganado, AZ 87571-6282
Phone (928) 755-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221115002190 NM Practitioner - Family Practice 5496167926 Reassigns benefits to 2 organizations
I20260213002299 AZ Practitioner - Family Practice 5496167926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taos Professional Services,LLCGroup PAC ID 6507019924, 30 clinicians

Practice addresses (Care Compare)

1329 Gusdorf Rd
Taos, NM 87571-6282
Phone (575) 751-8902

State Hwy 264 JCT Hwy 191
Ganado, AZ 86505-0457
Phone 92875545004933

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79194AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taos Health Systems Inc Holy Cross Hospital CurrentSince Oct 3, 2022 Accepting new patients
Taos Professional Services, LLC CurrentSince Oct 3, 2022 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Jan 12, 2026 Accepting new patients
Taos Professional Services,LLC CurrentSince Oct 3, 2022 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital CurrentSince Oct 3, 2022 Accepting new patients

Locations

1329 Gusdorf Rd
Taos, NM 87571
Phone (505) 758-5001

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1144719048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US 191 AND AZ 264",
            "city": "GANADO",
            "state": "AZ",
            "postal_code": "875716282",
            "telephone_number": "928-755-4500",
            "fax_number": "928-755-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CEDAR HILLS ROAD & AZ 264",
            "city": "GANADO",
            "state": "AZ",
            "postal_code": "86505",
            "telephone_number": "928-755-4500",
            "fax_number": "928-755-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "79194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ganado, AZ

Sources for this page

Verify at the official NPI Registry.