Ellis Franklin Fort III, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105205 Issued in FL

Practice address

502 Palmetto St
New Smyrna Beach, FL 32168

Phone

(386) 957-1854

Fax

(386) 878-4967

NPI assigned

Aug 16, 2010

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mdpa Solutions IncGroup PAC ID 8921301300, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: ellis.fort@napmp.eclinicaldirectplus.com

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.

• Mdpa Solutions, Inc

  • General Practice Physician
  • New Smyrna Beach, FL
  • NPI 1992181077
  Medicare reassignment Care Compare group Authorized official
• Apopka Wellness Center,Inc.

  • Chiropractor
  • Apopka, FL
  • NPI 1346420627
  Medicare reassignment
• Coastal Neurology, Inc.

  • Neurology Physician
  • Ormond Beach, FL
  • NPI 1457358434
  Medicare reassignment
• NDC of Volusia LLC

  • Neurology Physician
  • New Smyrna Beach, FL
  • NPI 1053759183
  Medicare reassignment

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1497060396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687325",
            "telephone_number": "869-571-8543",
            "fax_number": "386-878-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-957-1854",
            "fax_number": "386-878-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "ELLIS",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Cancer Specialists P L
• Florida Eye Clinic P.a.
• Florida Orthopaedic Associates PA
• Flynn Dental Holdings LLC
• Eugenia Forand, AP
• Frank W. Toub, M.D.
• Lindsey Franklin, PHARM.D.
• June Franz, MD
• Fred a Lecheler, DPM, PA
• John Fulginiti III, MD

• Physician Assistant in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.