Lori J Ellis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

264115 Issued in NY

Practice address

260 E Middle Country Rd
Suite 107
Smithtown, NY 11787-2982

Phone

(631) 979-7222

NPI assigned

May 15, 2009

Last updated

May 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Stony Brook Children's Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  Medicare reassignment NPD
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD
• Neurology Associates of Stony Brook, University Faculty Practice Corpo

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1699720888
  NPD (past)

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651881600000",
    "number": "1467687756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E MIDDLE COUNTRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872982",
            "telephone_number": "631-979-7222",
            "fax_number": "631-638-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E MIDDLE COUNTRY RD",
            "address_2": "SUITE 107",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872982",
            "telephone_number": "631-979-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LORI",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2022-05-07",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "264115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lori.ellis@direct.stonybrookmedicine.edu",
            "affiliation": "N",
            "address_1": "260 E Middle Country Rd",
            "address_2": "Suite 107",
            "city": "Smithtown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117872982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rawann Adel Elhalawani
• Judith A Elia, LCSW
• Elite Medical,PC (silverberg and nierman,md,pc)
• Deborah Lee Elkins, SPECIAL EDUCATOR
• Mohammed N Ellahi, PHARMD
• Emotional Health Counseling Consulting LCSW PC
• Empire Medicine & Rehabilitation
• Employee Assistance Resource Services
• Endocrine Associates of Long Island, PC
• Jamie Todd Eng

• Pediatrics Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; 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.