Misti G. Ellsworth, D.O.

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

N2486 Issued in TX

Practice address

6431 Fannin St
Suite JJL 495
Houston, TX 77030-1501

Phone

(713) 500-6645

Fax

(713) 500-5666

NPI assigned

Jan 15, 2008

Sex

Female

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mellsworth13356@direct.uth.org

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.

• Physicians Referral Service

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1073574810
  Medicare reassignment NPD
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Pediatrics

  Medicare reassignment NPD
• Ut Physicians

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1376729897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE JJL 495",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6645",
            "fax_number": "713-500-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE JJL 495",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6645",
            "fax_number": "713-500-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MISTI",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N2486",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TX",
            "license": "N2486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Ellison, MD
• Brogan Ellisor, RBT
• Mary Key Ellisor, LPC
• Carolina Coronel Elliston, LCSW
• Jessica Ellsworth, AU.D.
• Rachel Joy Ellsworth, M.D
• Warren Aldrich Ellsworth IV, MD
• Elly Med Devices LLC
• Barbara Ellzey, WHNP-LPA
• Hazem Elmansy, M.D.

• Pediatric Infectious Diseases Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Infectious Diseases Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.