Individual provider Active NPI

Marcus T Ellison, MD

  • Internal Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1174103550
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101282674 Issued in VA
Practice address
1222 Jefferson Park Ave
Charlottesville, VA 22903-3410
Phone
(434) 924-1931
Fax
(434) 244-4451
NPI assigned
Apr 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101282674 VA Primary

Addresses

Primary practice location

1222 Jefferson Park Ave
Charlottesville, VA 22903-3410

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240712004000 VA Practitioner - Internal Medicine 5092116160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1222 Jefferson Park Ave
FL 3
Charlottesville, VA 22903-3410
Phone (434) 924-1931

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince May 28, 2024 Accepting new patients

Locations

1222 Jefferson Park Ave
Fl 3
Charlottesville, VA 22903

1222 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-1774

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: marcus.ellison.1@20955.direct.athenahealth.com
  • Direct secure messaging: mellison486134@direct.healthsystem.virginia.edu

Organizations & group practices 1

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 1

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": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1174103550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033410",
            "telephone_number": "434-924-1931",
            "fax_number": "434-244-4451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "MARCUS",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101282674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.