Nicholas Ellyn, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101027634 Issued in VA

Practice address

1707 Osage St
Suite 205
Alexandria, VA 22302-2611

Phone

(703) 578-0100

Fax

(703) 824-8357

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nicholas.ellyn@pollackandellyn.direct.eyemdemr.com

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.

• Nicholas Ellyn, M.D., P.C.

  • Specialist
  • Alexandria, VA
  • NPI 1861715435
  NPD (past) Authorized official

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1174626311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "SUITE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022611",
            "telephone_number": "703-578-0100",
            "fax_number": "703-824-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "SUITE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022611",
            "telephone_number": "703-578-0100",
            "fax_number": "703-824-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLYN",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101027634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006380883",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174626311",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Elliott
• Megan Elliott
• Claras S Ellis, M.D.
• Katherine H Ellis, MD
• Craig M Ellison, MD
• Nora H Elnahas, NP
• Matt Elrod, PT
• Aileen Elsaesser, LPC
• Sohaib S. Elsayed, MD
• Dania Elshaer

• Ophthalmology Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.