Individual provider Active NPI

Austin Ellyson, DO

  • Ophthalmology Physician
  • Tacoma, WA
National Provider Identifier
1215322573
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1540 Issued in NE
Practice address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone
(253) 968-1760
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X T3764 TX
Ophthalmology Physician 207W00000X 1540 NE Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-0001

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.11 of 100Reported as group
Quality
99.82
Improvement activities
40
Cost
77.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1540NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye & Ocular Surface Center of Texas LLC Ophthalmology CurrentSince Jan 1, 2022 Accepting new patients
Surgical Center of Excellence LLC PastSince Sep 8, 2024 Accepting new patients
Complete Surgery of El Paso LLC PastSince Jan 1, 2022 Accepting new patients

Locations

600 N Laurel St
El Paso, TX 79903
Phone (915) 261-7011

3235 Trawood Dr
El Paso, TX 79936
Phone (915) 261-7011

5662 N Mesa St
El Paso, TX 79912
Phone (915) 261-7011

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1215322573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLYSON",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "T3764",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NE",
            "license": "1540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.