Michael Isaac Ellenbogen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125059268 Issued in IL

Practice address

251 E Huron St Ste 16-738
Chicago, IL 60611-2908

Phone

(312) 926-5924

Fax

(312) 926-6134

NPI assigned

Jun 4, 2011

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

Merit-based Incentive Payment System (MIPS)

Final score

83.31 of 100Reported as group

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Cost

70.47

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1336433697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 16-738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-5924",
            "fax_number": "312-926-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 16-738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-5924",
            "fax_number": "312-926-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "MICHAEL",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-04",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125059268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Gao Aprn, LLC
• Ellen Kozob, Inc
• Ellen M Griffin PSYD PC
• Ellen Rosendale, LCSW, PLLC
• Sara Ellena, OTR/L
• Elles Nurturing Nook LLC
• Don Gregory Elligan, PH.D.
• Stephanie Ellinghaus, OT
• Bridgid Ellingson, PT, DPT
• Jamie Ellingwood, PA

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.