Haley Marie Ellis, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP001704 Issued in SD

Practice address

401 9TH Ave NW
Watertown, SD 57201-1548

Phone

(605) 882-7000

Fax

(605) 882-7819

NPI assigned

Dec 27, 2019

Last updated

Mar 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005
• Coteau Des Prairies Health Care System Hospital, Sisseton, SD, CCN 431339
• Ortonville Area Health Services Hospital, Ortonville, MN, CCN 241342
• Milbank Area Hospital/Avera Health Hospital, Milbank, SD, CCN 431326
• Sanford Hospital Webster - Cah Hospital, Webster, SD, CCN 431311

Merit-based Incentive Payment System (MIPS)

Final score

94.59 of 100Reported as group

Quality

100

Promoting interoperability

96

Improvement activities

40

Cost

85.3

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prairie Lakes Health Care System Inc

  dba Sanford Watertown Specialty Clinic

  • Rural Acute Care Hospital
  • Watertown, SD
  • NPI 1720166002

  MN

  Medicare reassignment Care Compare group NPD
• Prairie Lakes Health Care System Inc

  dba Sanford Health Castlewood Clinic

  • Family Medicine Physician
  • Castlewood, SD
  • NPI 1578369070
  NPD
• Prairie Lakes Health Care System Inc

  dba Prairie Lakes Brown Clinic

  • Family Medicine Physician
  • Watertown, SD
  • NPI 1396525143
  NPD (past)

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

• Avera McKennan

  dba Milbank Area Hospital/Avera Health

  • Critical Access Hospital
  • Milbank, SD
  • NPI 1548272818
  Care Compare affiliation
• Avera McKennan

  dba Avera Medical Group Milbank

  • Rural Health Clinic/Center
  • Milbank, SD
  • NPI 1750488730

  Hospital

  Care Compare affiliation
• Coteau Des Prairies Hospital

  dba Coteau des Prairies Health Care System

  • Critical Access Hospital
  • Sisseton, SD
  • NPI 1417051517
  Care Compare affiliation
• Sanford Health Network

  dba Sanford Webster Medical Center

  • Critical Access Hospital
  • Webster, SD
  • NPI 1831103449
  Care Compare affiliation
• Ortonville Area Health Services

  • Critical Access Hospital
  • Ortonville, MN
  • NPI 1790783587
  Care Compare affiliation

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1306485172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HALEY",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001704",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R036298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dawn Eide, COTA/L
• Emily Eisenbraun
• Jvonne L Ellingson, CCDCT
• Joseph Turner Elliott III, M.D.
• Kasey Sue Ellis-Van Liere
• Embrace 212 LLC
• Embrace Behavior Services LLC
• Empathy Now Inc
• Empower Psychological Services LLC
• Ann Marie Endres, RPH

• Family Nurse Practitioner in Watertown, SD
• Providers in Watertown, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.