Active NPI
Michelle Ellis, M.D..
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Appleton, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 67697-20
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 731-8900
- Fax
- (920) 738-5369
- NPI assigned
- May 31, 2007
- Last updated
- Oct 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 56534 | TN | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 67697-20 | WI | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 4301100710 | MI | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 51276 | MT |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900
Other practice location 1
2900 12th Ave N
Suite 400E
Billings, MT 59101-7506
Phone (406) 238-6820
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of New Mexico School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 735-7645
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51276 | MT | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| 56534 | TN | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Thedacare, Incorporated | Current | Accepting new patients | |
| MCHS Hospitals, Inc. | Current | Accepting new patients | |
| Thedacare, Incorporated | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients |
Locations
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
2310 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133
425 Pine Ridge Blvd
Ste 209
Wausau, WI 54401
Phone (715) 845-4606
Interoperability endpoints
- him@marshfieldclinichealthsystem.cernerdirect.com
- mellis371694@direct.hfhs.org
Organizations & group practices 7
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.
-
dba ThedaCare Physicians
- Family Medicine Physician
- New London, WI
- NPI 1376656959
-
dba Marshfield Medical Center - Rice Lake Professional Services
- Clinic/Center
- Rice Lake, WI
- NPI 1093201832
-
dba Marshfield Clinic Florida Teleradiology/Telehealth
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
-
dba Marshfield Medical Center - Eau Claire Cancer Center
- Durable Medical Equipment & Medical Supplies
- Eau Claire, WI
- NPI 1558230847
-
dba Marshfield Medical Center Ladysmith
- Medicare Defined Swing Bed Hospital Unit
- Ladysmith, WI
- NPI 1346716263
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba ThedaCare Medical Center Orthopedics, Spine, and Pain
- General Acute Care Hospital
- Appleton, WI
- NPI 1740920909
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1497119218
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1689038408
-
dba WI Veterans Village Physical Therapy
- General Acute Care Hospital
- Appleton, WI
- NPI 1831773589
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1902832306
-
dba ThedaCare Medical Center - Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1912721002
-
dba ThedaCare Medical Center - Oshkosh
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1912880329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1194926600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-830-5900",
"fax_number": "920-830-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 N MEADE ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549113454",
"telephone_number": "920-731-8900",
"fax_number": "920-738-5369"
}
],
"practiceLocations": [
{
"address_1": "2900 12th Ave N",
"address_2": "Suite 400E",
"address_purpose": "LOCATION",
"city": "Billings",
"state": "MT",
"postal_code": "591017506",
"country_code": "US",
"telephone_number": "406-238-6820",
"fax_number": "406-238-6838",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "MICHELLE",
"credential": "M.D..",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "TN",
"license": "56534",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "WI",
"license": "67697-20",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MI",
"license": "4301100710",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MT",
"license": "51276",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"address_1": "2900 12th Ave N",
"address_2": "Suite 400E",
"city": "Billings",
"state": "MT",
"country_code": "US",
"postal_code": "591017506",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.