Herman Martin Ellis, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

C10007434 Issued in DE

Practice address

100 Biddle Ave Ste 101
Newark, DE 19702-3982

Phone

(410) 505-8605

Fax

(240) 770-0436

NPI assigned

Mar 19, 2007

Sex

Male

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 DE

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 Medicine

State licenses

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.

• Ramazzini Occupational Health Associates

  • Public Health & General Preventive Medicine Physician
  • Newark, DE
  • NPI 1831917533
  Medicare reassignment NPD Authorized official
• The Life Center Complex, Inc

  • Community Health Clinic/Center
  • Wilmington, DE
  • NPI 1770808578
  Medicare reassignment NPD
• CLH Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaford, DE
  • NPI 1063154110
  NPD
• CLH Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seaford, DE
  • NPI 1275270936
  NPD
• The Life Center Complex, Inc

  • Student Health Clinic/Center
  • Wilmington, DE
  • NPI 1366114522
  NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1386768612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 OLD ANNAPOLIS RD STE 203&204",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451953",
            "telephone_number": "410-505-8605",
            "fax_number": "240-770-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BIDDLE AVE STE 101",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023982",
            "telephone_number": "410-505-8605",
            "fax_number": "240-770-0436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9123 Old Annapolis Rd Ste 203&204",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210451953",
            "country_code": "US",
            "telephone_number": "410-505-8605",
            "fax_number": "240-770-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HERMAN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-06-06",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "DE",
            "license": "C1-0007434",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "DE",
            "license": "C10007434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Home Health Care Inc
• Daniel J Elliott, MD MSCE
• Lauren Falin Elliott, PA-C
• Sandra E Elliott, CNM, MSN
• Colleen Ellis, FNP-C
• Emma C. Ellman-Groves, PA-C
• Sherif Elsayed, MD
• Ahmad Eltejaye, D.M.D, M.P.H
• Alicia K Ely, DO
• Kari Ann Elzey, LAT, ATC

• Addiction Medicine (Preventive Medicine) Physician in Newark, DE
• Providers in Newark, DE by specialty
• Addiction Medicine (Preventive Medicine) Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.