Ellis Tavin, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

41308 Issued in TN

Practice address

80 Humphreys Center Dr
#100
Memphis, TN 38120

Phone

(901) 761-9030

Fax

(901) 473-6505

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Plastic and Reconstructive SurgeryAlso: Otolaryngology

Education

Albert Einstein College of Medicine of Yeshiva University, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Plastic Surgery Group of Memphis P.C.Group PAC ID 6608854013, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: etavin26016@mlh.direct-ci.com
• Direct secure messaging: ellis.tavin@psgm.eclinicaldirectplus.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.

• The Plastic Surgery Group of Memphis P.C.

  • Plastic Surgery Physician
  • Memphis, TN
  • NPI 1831102078
  Medicare reassignment Care Compare group

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

• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1326003179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 N BROTHER BLVD",
            "address_2": "STE 200",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381332760",
            "telephone_number": "901-255-5221",
            "fax_number": "901-373-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HUMPHREYS CENTER DR",
            "address_2": "#100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-761-9030",
            "fax_number": "901-473-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVIN",
        "first_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "9601744",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "41308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89100200",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh Scotten Tatum, LCSW
• Maia Briana Tatum, PHARM. D
• Robert Tatum Jr., MD
• Marc Brian Taub, OD
• Caroline Augusta Taufic
• Taylor & Steer Enterprises Inc
• Taylor Brown Garden Healthcare LLC
• Taylor Brown Incorporation
• Tommie Taylor-Macklin
• Jacquelyn Leatrice Taylor-Mays, LCSW

• Plastic Surgery Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Plastic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.