Individual provider Active NPI

Christie Ann Ellis

  • Certified Registered Nurse Anesthetist
  • Danvers, MA
National Provider Identifier
1235522087
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2289067 Issued in MA
Practice address
480 Maple St
Suite C233A
Danvers, MA 01923-4065
Phone
(978) 304-8691
NPI assigned
Mar 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN2289067 MA Primary

Addresses

Primary practice location

480 Maple St
Suite C233A
Danvers, MA 01923-4065

Mailing address

9 Woodland Rd
Wakefield, MA 01880-3120

Other practice location 1

41 Mall Rd
Burlington, MA 01805-4065
Phone (781) 744-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150420000316 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325366578 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pratt Anesthesiology Associates IncGroup PAC ID 0547151151, 153 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-6044

Hospital & facility affiliations

  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2289067MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Anesthesiology Associates, Inc CurrentSince Oct 14, 2023 Accepting new patients
Beverly Anesthesia Associates, Inc. CurrentSince Apr 15, 2015 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Nov 1, 2023 Accepting new patients

Locations

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

480 Maple St
#C233A
Danvers, MA 01923

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

480 Maple St
Ste C233A
Danvers, MA 01923
Phone (978) 304-8690

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1235522087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WOODLAND RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAPLE ST",
            "address_2": "SUITE C233A",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234065",
            "telephone_number": "978-304-8691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018054065",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHRISTIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2289067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.