Erik G Ellsworth, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

41569 Issued in AZ

Practice address

1501 N Gilbert Rd Ste 203
Gilbert, AZ 85234-2394

Phone

(602) 933-3366

Fax

(602) 933-4264

NPI assigned

Jan 19, 2006

Last updated

Sep 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

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

Cardiac SurgeryAlso: Pediatric Medicine

Education

Mayo Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Children's HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Children's Hospital Hospital, Phoenix, AZ, CCN 033302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Phoenix Children's Hospital

  dba Phoenix Children's Medical Group

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment Care Compare group NPD
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1679703441
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Pediatrics

  NPD (past)
• Obstetrix Medical Group of Phoenix PC

  dba Arizona Pediatric Cardiology Consultants

  • Pediatric Cardiology Physician
  • Phoenix, AZ
  • NPI 1346269594
  NPD (past)
• Obstetrix Medical Group of Phoenix PC

  dba Phoenix Perinatal Associates

  • Neonatal-Perinatal Medicine Physician
  • Mesa, AZ
  • NPI 1407957152
  NPD (past)
• Phoenix Children's Hospital

  • Children's Hospital
  • Phoenix, AZ
  • NPI 1760480503
  NPD (past)
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD (past)

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

• Phoenix Children's Hospital

  • Children's Hospital
  • Phoenix, AZ
  • NPI 1760480503
  Care Compare affiliation

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1306826896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N GILBERT RD STE 203",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342394",
            "telephone_number": "602-933-3366",
            "fax_number": "602-933-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "ERIK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "41569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404994",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellis DDD Services
• Erin Brett Ellis, NMD
• Robert Michael Ellis, NP
• Scott Joseph Ellis, M.D.
• Chantel Lanae Ellsworth, MAED
• Kevin Ryan Ellsworth, M.D.
• Marc Andrew Ellsworth, MD
• Michele Lee Ellsworth
• Rachel Elizabeth Ellsworth
• Elmahi Abdeldaiem Elmahi

• Pediatric Cardiology Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Pediatric Cardiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.