Michael R Ellis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

151833 Issued in WA

Practice address

101 W 8TH Ave
Spokane, WA 99204-2307

Phone

(509) 474-3131

NPI assigned

Aug 26, 2024

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Tennessee, HSC, College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Providence Health & Service- Washington

  • Anesthesiology Physician
  • Spokane, WA
  • NPI 1508118555
  Medicare reassignment Care Compare group NPD
• Spokane Digestive Disease Center, P.S.

  • Gastroenterology Physician
  • Spokane, WA
  • NPI 1699808873
  Medicare reassignment

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

• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1225289895
  Care Compare affiliation

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1326871104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S CLOVER DR",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990165081",
            "telephone_number": "801-372-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "000265583",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "151833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalai Ellis-Goings
• Daniel Adam Ellis, L.D.O.
• Erika Ellis, DPT
• James Randall Ellis, MA, LMHC
• Jessica Ann Ellis, OD
• Stacie Ellis
• Aliece Ellisen, PTA
• Madison Ellison
• Charity A Elmendorf, ARNP
• Karen L Elmendorf, RN

• Certified Registered Nurse Anesthetist in Spokane, WA
• Providers in Spokane, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.