Active NPI
Erin Ellis
- Mental Health Counselor
- New York, NY
National Provider Identifier
1144926635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 013179
- Practice address
- 109 W 27TH St Ste 5S
New York, NY 10001-0265 - Phone
- (833) 351-8255
- NPI assigned
- Feb 6, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 013179 | NY | Primary |
Addresses
Primary practice location
109 W 27TH St Ste 5S
New York, NY 10001-0265
Mailing address
PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255
Other practice location 1
56 Manorshire Dr Apt 6
Fairport, NY 14450-3425
Phone (585) 481-0239
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD Psychiatry Services PLLC | Current | Accepting new patients | |
| Shine Medical Providers PC | Past | Accepting new patients |
Locations
109 W 27th St
#55
New York, NY 10001
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
Organizations & group practices 2
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.
-
- Psychiatry Physician
- New York, NY
- NPI 1033750823
-
- Psychiatry Physician
- Philadelphia, PA
- NPI 1538894050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1144926635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24449",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100870589",
"telephone_number": "833-351-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W 27TH ST STE 5S",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100010265",
"telephone_number": "833-351-8255"
}
],
"practiceLocations": [
{
"address_1": "56 Manorshire Dr Apt 6",
"address_purpose": "LOCATION",
"city": "Fairport",
"state": "NY",
"postal_code": "144503425",
"country_code": "US",
"telephone_number": "585-481-0239",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "ERIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-06",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "013179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.