Individual provider Active NPI

Nandi Lee-Ellis, MD

  • Anesthesiology Physician
  • Passaic, NJ
National Provider Identifier
1376842740
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA08948700 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 365-4300
Fax
(845) 357-5777
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA08948700 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

100 Route 59
Suite 105
Suffern, NY 10901-4927
Phone (845) 357-5775

Other identifiers 1

IdentifierTypeStateIssuer
0269930MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20110907001014 NJ Practitioner - Anesthesiology 9931379682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Anesthesiology CurrentSince Jul 20, 2022 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Mar 4, 2021 Accepting new patients

Locations

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1376842740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59",
            "address_2": "SUITE 105",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014927",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4300",
            "fax_number": "845-357-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-ELLIS",
        "first_name": "NANDI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08948700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0269930",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.