NPIMap

Individual provider Active NPI

Paul T Ellis, MD

  • Urology Physician
  • Spartanburg, SC
National Provider Identifier
1356317325
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
17866 Issued in SC
Practice address
391 Serpentine Dr
Suite 500
Spartanburg, SC 29303-3083
Phone
(864) 585-8211
NPI assigned
Feb 28, 2006
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 17866 SC Primary

Addresses

Primary practice location

391 Serpentine Dr
Suite 500
Spartanburg, SC 29303-3083

Mailing address

107 Club Pointe Dr
Spartanburg, SC 29302-6313
Phone (864) 582-7098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000538 SC Practitioner - Urology 6406833243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wright State University Boonshoft School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-1576

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Urology CurrentSince Dec 1, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Upstate Carolina Radiology PA PastSince Jul 1, 2004 Accepting new patients

Locations

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

391 Serpentine Dr
Ste 500
Spartanburg, SC 29303
Phone (864) 585-8221

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

853 N Church St
Ste 701
Spartanburg, SC 29303
Phone (864) 560-1650

319 W South St
Union, SC 29379
Phone (864) 427-8380

Organizations & group practices 5

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.

Hospital & facility affiliations 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1356317325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CLUB POINTE DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293026313",
            "telephone_number": "864-582-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SERPENTINE DR",
            "address_2": "SUITE 500",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033083",
            "telephone_number": "864-585-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "PAUL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "17866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.