Lixia Zhao Ellis, M.D., PH.D.
Individual provider Active NPI Dermatology Physician · Bennington, VT
NPI 1285861674 · NPPES record last updated Mar 17, 2014
Key facts
- NPI
- 1285861674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 042.0012576 (VT)
- Practice address
- 100 Hospital Dr
Bennington, VT 05201-5004 - Phone
- (802) 447-5544
- NPI assigned
- Jun 12, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Harvard Medical School, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwestern Vermont Medical Center, Inc
Practice addresses (Care Compare)
140 Hospital Dr
Suite 108
Bennington, VT 05201-5010
Phone (802) 447-5519
Hospital & facility affiliations
- Southwestern Vermont Medical Center
- Berkshire Medical Center
- Rutland Regional Medical Center
- Grace Cottage Hospital
- North Adams Regional Hospital Corporation
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 54 |
| Removal of skin lesions | 1627 |
| Removal or shaving of skin growth | 130 |
| Skin biopsy | 154 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130723000010 | VT | Practitioner - Dermatology | 4587805254 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TL-3746 | CO | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Vermont Medical Center Inc. | Current |
Accepting new patients | |
| Southwestern Vermont Medical Center Inc. | Current |
Accepting new patients |
Locations
140 Hospital Dr
Ste 205
Bennington, VT 05201
Phone (802) 447-2677
140 Hospital Dr
Ste 108
Bennington, VT 05201
Phone (802) 447-1191
100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509
140 Hospital Dr
Bennington, VT 05201
Phone (802) 442-3520
140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | TL-3746 | CO | |
| Dermatology Physician | 207N00000X | 042.0012576 | VT | Yes |
Addresses
Primary practice location
100 Hospital Dr
Bennington, VT 05201-5004
Mailing address
140 Hospital Dr
Bennington, VT 05201-5009
Phone (802) 447-5544
Other names
- Dr. Lixia Zhao
Other providers in Bennington, VT
- Jerry Durgin
- Aron Jon Efimenko
- Stacy D'Lynn Eggsware
- Thomas Mitchell Eggsware II
- Karen Ejeriefe
- William Elwell
- Emeritus Corporation
- Emil P. Miskovsky MD PC
- Zekariah England
- Mark Epler
All providers in Bennington, VT · Dermatology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.