Michael Gary Ellman, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3092 Issued in TX

Practice address

2692 N Galloway
402
Mesquite, TX 75150-2636

Phone

(972) 682-3909

Fax

(972) 682-9289

NPI assigned

Sep 21, 2006

Last updated

May 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ellman Rehab Associates PA

  • Specialist
  • Mesquite, TX
  • NPI 1912028804
  Authorized official Same address or phone
• Regenerative Ortho Spine Institute of Texas P.a.

  • Pain Medicine Physician
  • Mesquite, TX
  • NPI 1255674867
  Authorized official Same address or phone

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1245339977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850304",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751850304",
            "telephone_number": "972-682-3909",
            "fax_number": "972-682-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2692 N GALLOWAY",
            "address_2": "402",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502636",
            "telephone_number": "972-682-3909",
            "fax_number": "972-682-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLMAN",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12249902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elite Champions Adult Day Center
• Elite EMS Inc
• Reem Elkorashy
• Rebekah Lynn Ellis, NP-C
• Ellman Rehab Associates PA
• Charissa Elton-Lacasse, NP-C
• Emcare MSQ Emergency Physicians
• Emer Mesquite Gus Thomasson Physicians, PLLC
• Emer Mesquite Gus Thomasson, LLC (Surepoint Emergency Center Mesquite)
• Emer Mesquite Samuell Farm Physicians, PLLC

• Specialist in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.