Jonathan D Ellen, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

26906 Issued in TN

Practice address

4441 E Lohman Ave
Las Cruces, NM 88011-8267

Phone

(901) 484-2052

NPI assigned

Sep 14, 2006

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Physical Medicine and Rehabilitation

Education

New York University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gila Regional Medical Center Hospital, Silver City, NM, CCN 321311
• Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085
• Rehabilitation Hospital of Southern New Mexico,Inc Inpatient rehabilitation facility, Las Cruces, NM, CCN 323032

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

• Jonathan Ellen MD PC

  • Physical Medicine & Rehabilitation Physician
  • Las Cruces, NM
  • NPI 1851848360
  Medicare reassignment NPD Authorized official
• Rehabilitation Hospital of Southern New Mexico, Inc

  • Rehabilitation Hospital
  • Las Cruces, NM
  • NPI 1679578066
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gila Regional Medical Center

  • Critical Access Hospital
  • Silver City, NM
  • NPI 1336220839
  Care Compare affiliation
• Las Cruces Medical Center LLC

  dba Mountainview Regional Medical Center

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1205882503
  Care Compare affiliation
• Rehabilitation Hospital of Southern New Mexico, Inc

  • Rehabilitation Hospital
  • Las Cruces, NM
  • NPI 1679578066

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1477658094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 0420",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480420",
            "telephone_number": "901-484-2052",
            "fax_number": "901-507-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118267",
            "telephone_number": "901-484-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEN",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "26906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy Ellis-Restrepo, CASE MANAGER
• Rebecca L Ellis, CNP

• Physical Medicine & Rehabilitation Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Physical Medicine & Rehabilitation Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.