Troy C Ellis, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

49391 Issued in AZ

Practice address

13943 N 91St Ave
#C-101
Peoria, AZ 85381-3629

Phone

(623) 760-9449

Fax

(623) 974-9351

NPI assigned

Jan 12, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Dermatology

Education

Columbia University College of Physicians and Surgeons, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926
  Medicare reassignment Care Compare group NPD
• Southwest Skin Specialists, LLC

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1609185347
  NPD

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1356491997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE",
            "address_2": "#C-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813629",
            "telephone_number": "623-760-9449",
            "fax_number": "623-974-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE",
            "address_2": "#C-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813629",
            "telephone_number": "623-760-9449",
            "fax_number": "623-974-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TROY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "49391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4847313",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1356491997",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2868924",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elk Bridge Homes, LLC
• Ellah Health Specialties, Inc.
• Richard Schindler Elliott, MD
• Eric Edward Ellis, DMD
• Madeline Wood Ellis, PA
• Julie E Ellison
• Mistie Rose Ellsworth
• Elnazer LLC
• Tamara Monet Else
• Veronica Leticia Elstro, FNP-C

• Dermatology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.