Jeffrey Ira Ellis, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

234545-01 Issued in NY

Practice address

358 S Oyster Bay Rd
Hicksville, NY 11801-3508

Phone

(516) 822-7546

Fax

(516) 937-7546

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

State University of New York Downstate Medical Center, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Belaray Dermatology PCGroup PAC ID 0941398671, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.75 of 100Reported as group

Quality

100

Improvement activities

40

Cost

89.16

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: direct@belaray.compulinkdirect.com

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.

• Belaray Dermatology PC

  • Dermatology Physician
  • Hicksville, NY
  • NPI 1225237886
  Medicare reassignment Care Compare group NPD
• Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1720028772
  Medicare reassignment NPD
• Interfaith Professional Physician Services, P.C.

  • Allergy Physician
  • Brooklyn, NY
  • NPI 1457643991

  Dermatology

  Medicare reassignment NPD
• New York Queens Medicine and Surgery, P.C.

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment NPD
• Newyork-Presbyterian/Queens

  • Cardiovascular Disease Physician
  • Flushing, NY
  • NPI 1013960962
  Medicare reassignment NPD
• New York Queens Medicine and Surgery, P.C.

  • Multi-Specialty Clinic/Center
  • Flushing, NY
  • NPI 1740792233
  NPD
• Newyork-Presbyterian-Queens

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1689958779
  NPD
• The Brookdale Hospital Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1639756406
  NPD
• Rachel Ellis MD PLLC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Hicksville, NY
  • NPI 1245507961
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1285748293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 S OYSTER BAY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013508",
            "telephone_number": "516-822-7546",
            "fax_number": "516-937-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 S OYSTER BAY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013508",
            "telephone_number": "516-822-7546",
            "fax_number": "516-937-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JEFFREY",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "234545",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "234545",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NY",
            "license": "234545",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "234545-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@belaray.compulinkdirect.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "358 S Oyster Bay Rd",
            "city": "Hicksville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "118013508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hanaa Elfiky, CASAC-T
• Mariel Eliza, MD
• Ayah Elkady
• Mehreen Ellahi, PHARM D
• Elliot T Udell DPM PC
• Rachel Fremder Ellis, M.D.
• Paige Nicole Ellison, LCSW
• Victoria Rose Elwell
• Epilepsy Foundation of Li
• Epiq Medical, PC

• Procedural Dermatology Physician in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Procedural Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.

Verify at the official NPI Registry.