Individual provider Active NPI

Margaret A Ellis

  • Physician Assistant
  • State College, PA
National Provider Identifier
1407276728
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3901 S Atherton St
Suite 5
State College, PA 16801-8324
Phone
(814) 466-7921
Fax
(814) 466-6570
NPI assigned
Apr 25, 2014
Last updated
Apr 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3901 S Atherton St
Suite 5
State College, PA 16801-8324

Mailing address

3901 S Atherton St
Suite 5
State College, PA 16801-8324
Phone (814) 466-7921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141024000479 PA Practitioner - Physician Assistant 9436370046 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc CurrentSince Feb 12, 2018 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

129 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-2762

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

143 Hospital Dr
Ste 301
State College, PA 16803
Phone (814) 237-3470

164 Greenview Dr
Ste 145
State College, PA 16803

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

3901 S Atherton St
#5
State College, PA 16801

3901 S Atherton St
Ste 5
State College, PA 16801
Phone (814) 466-7921

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1407276728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 S ATHERTON ST",
            "address_2": "SUITE 5",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168018324",
            "telephone_number": "814-466-7921",
            "fax_number": "814-466-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 S ATHERTON ST",
            "address_2": "SUITE 5",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168018324",
            "telephone_number": "814-466-7921",
            "fax_number": "814-466-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARGARET",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.