John L Ellis II, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5395T6 Issued in TX

Practice address

3800 N Mesa
Ste C8
El Paso, TX 79902

Phone

(915) 533-1811

Fax

(915) 533-3641

NPI assigned

Oct 21, 2005

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blair and Ellis P.a.Group PAC ID 9739394891, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Blair and Ellis P.a.

  dba University Vision Centre

  • Optometrist
  • El Paso, TX
  • NPI 1104950989
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1417947417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N MESA ST",
            "address_2": "STE B1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021535",
            "telephone_number": "915-533-1811",
            "fax_number": "915-533-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N MESA",
            "address_2": "STE C8",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79902",
            "telephone_number": "915-533-1811",
            "fax_number": "915-533-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5395T6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PALMETTO",
            "identifier": "4722920001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "807829",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "914210",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "06654720",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160390401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION",
            "identifier": "5395",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00113768",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE VISION",
            "identifier": "143852",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karem Elizondo, PHARMD
• Ammar Fadlalla Eljack, MD
• Ezra Samuel Elkayam, MD
• Gregory C. Elkins, MD
• Kaisa Elliott
• Linda Suzanne Ellis, MD
• Mariah Alyss Ellis
• Sarah Michelle Ellis, FNP-C
• Steven Lee Ellis, D.O.
• Patricia E Ellison, OTR

• Optometrist in El Paso, TX
• Providers in El Paso, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.
• 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.