Eugene Ellis, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

136939-1 Issued in NY

Practice address

967 48TH St
Brooklyn, NY 11219-2919

Phone

(718) 283-3000

Fax

(718) 238-6818

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eellis167515@direct-guthrie.org
• Direct secure messaging: eugeneellis@mai.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.

• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment NPD
• Nsuh Plainview Physicians Ufp Corporation

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1508750332
  Medicare reassignment NPD
• St. Barnabas OB GYN, PC

  • Obstetrics & Gynecology Physician
  • Bronx, NY
  • NPI 1124060595

  Specialist

  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Bethpage Medical, PLLC

  • Obstetrics & Gynecology Physician
  • Garden City, NY
  • NPI 1205074739
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1194721142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192919",
            "telephone_number": "718-283-3000",
            "fax_number": "718-238-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192919",
            "telephone_number": "718-283-3000",
            "fax_number": "718-238-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "136939-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01862853",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Ellis
• Catherine Elizabeth Ellis, DO
• Cynthia Marie Ellis, LCSW,CASAC
• Darnette Ann-Marie Ellis, LMSW
• Earl Anthony Ellis, MD
• Gavin N Ellis
• Gloria Laraine Ellis, R.N.
• Jasmine Ellis
• Judith M Ellis, NP
• Julia Alexandra Ellis, LMSW

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.