NPIMap

Organization Active NPI

Eric L Ellis MD Inc

Doing business as Lincoln Urgent Care

  • Urgent Care Clinic/Center
  • Lincoln, CA
National Provider Identifier
1386118305
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ERIC L ELLIS MD INC
Doing business as
Lincoln Urgent Care
Practice address
77 Lincoln Blvd Ste 1
Lincoln, CA 95648-7422
Phone
(916) 258-2751
Fax
(916) 258-7172
NPI assigned
Jan 12, 2019
Last updated
Mar 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Eric Lee Ellis, MDNPI 1215968409
Title
President
Phone
(916) 258-2751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

77 Lincoln Blvd Ste 1
Lincoln, CA 95648-7422

Mailing address

77 Lincoln Blvd Ste 1
Lincoln, CA 95648-7422

Other practice location 1

5290 Douglas Blvd
Granite Bay, CA 95746
Phone (916) 258-2751

Other practice location 2

5007 Foothills Blvd
Roseville, CA 95747-6503
Phone (916) 727-6846

Other identifiers 1

IdentifierTypeStateIssuer
CA333419MedicaidCA

Other names 1

  • Lincoln Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190222002332 CA Part B Supplier - Clinic/Group Practice 9032458815 Receives reassigned benefits from 21 practitioners
Practice locations: Roseville, CA; Lincoln, CA; Granite Bay, CA
O20200319002380 CA DME Supplier - Physician - Emergency Medicine 9032458815 Practice locations: Lincoln, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2164170Eric L Ellis MD Inc / Lincoln Urgent Care77 Lincoln Boulevard, Suite 1, Lincoln, CA 95648AccreditationNov 25, 2026
05D2263079Eric L. Ellis MD, Inc.5290 Douglas Blvd Ste 102, Granite Bay, CA 95746RegistrationAug 15, 2026

National Provider Directory

National Provider Directory

Locations

5290 Douglas Blvd
Granite Bay, CA 95746
Phone (916) 258-2751

5290 Douglas Blvd
Ste 102
Granite Bay, CA 95746

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1547251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1386118305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 LINCOLN BLVD STE 1",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 LINCOLN BLVD STE 1",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487422",
            "telephone_number": "916-258-2751",
            "fax_number": "916-258-7172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5290 Douglas Blvd",
            "address_purpose": "LOCATION",
            "city": "Granite Bay",
            "state": "CA",
            "postal_code": "95746",
            "country_code": "US",
            "telephone_number": "916-258-2751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5007 Foothills Blvd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "957476503",
            "country_code": "US",
            "telephone_number": "916-727-6846",
            "fax_number": "916-900-0947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERIC L ELLIS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-12",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-258-2751",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA333419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lincoln Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.