NPIMap

Organization Active NPI

Adelis Health PLLC

Doing business as Ellie Mental Health MA-Medford-Boston Avenue

  • Mental Health Counselor
  • Medford, MA
National Provider Identifier
1225808785
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ADELIS HEALTH PLLC
Doing business as
Ellie Mental Health MA-Medford-Boston Avenue
Practice address
200 Boston Ave Ste 1925
Medford, MA 02155-4243
Phone
(617) 533-0416
NPI assigned
Jan 5, 2024
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Mr. Aditya Srinivas
Title
Owner
Phone
(585) 309-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

200 Boston Ave Ste 1925
Medford, MA 02155-4243

Mailing address

200 Boston Ave Ste 1925
Medford, MA 02155-4243

Other names 1

  • Ellie Mental Health MA-Medford-Boston Avenue Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250618003409 MA Part B Supplier - Clinic/Group Practice 7315458072 Receives reassigned benefits from 9 practitioners
Practice locations: Medford, MA

National Provider Directory

National Provider Directory

Locations

200 Boston Ave
Ste 1925
Medford, MA 02155
Phone (617) 221-9742

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1225808785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOSTON AVE STE 1925",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOSTON AVE STE 1925",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554243",
            "telephone_number": "617-533-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADELIS HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "SRINIVAS",
        "authorized_official_first_name": "ADITYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-309-2333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health MA-Medford-Boston Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.