Jonathan C Ellis, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G52023 Issued in CA

Practice address

9090 Wilshire Blvd
Suite 101
Beverly Hills, CA 90211-1848

Phone

(310) 246-2520

Fax

(310) 659-6237

NPI assigned

Jul 4, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 25, 2015 through Nov 25, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Doheny Endosurgical Center Inc

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
  • NPI 1881642288
  NPD (past) Authorized official
• Tower Digestive Health Medical Group

  • Gastroenterology Physician
  • Beverly Hills, CA
  • NPI 1558392597
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1306876263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9090 WILSHIRE BLVD",
            "address_2": "SUITE 101",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111848",
            "telephone_number": "310-550-0400",
            "fax_number": "310-285-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 WILSHIRE BLVD",
            "address_2": "SUITE 101",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111848",
            "telephone_number": "310-246-2520",
            "fax_number": "310-659-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G52023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Outpatient Surgery Center Inc
• Elizabeth Kim, MD, Inc.
• Rayan Abdo Elkattah, M.D.
• Leah Ellenberg, PH.D.
• Ellie Adhami Psychotherapy Inc.
• Tyler Ellis
• Bruce Ellman, PSYD
• Rachel Ann Elsasser, D.O.
• Elsz Medical, Inc., a Professional Corporation
• Rebecca Elyasi

• Gastroenterology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.