Marco Fredrick Ellis, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036121419 Issued in IL

Practice address

259 E Erie St Ste 20-2060
Chicago, IL 60611-2987

Phone

(312) 695-6022

Fax

(312) 695-5672

NPI assigned

Jul 23, 2008

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 1

Medicare fee-for-service enrollment

Enrolled in IL

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

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314

  IL

  Medicare reassignment Care Compare group NPD
• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896

  IL

  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819

  IL

  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  Care Compare group NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Evanston, IL
  • NPI 1124733019
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1275759789
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Glenview, IL
  • NPI 1316590409
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1376961524
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Eyewear Supplier
  • Evanston, IL
  • NPI 1427741909
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Lake Forest, IL
  • NPI 1467005520
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1497308340
  Care Compare group
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Oak Brook, IL
  • NPI 1497516454
  Care Compare group

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

• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497859649

  Hospital

  Care Compare affiliation

Specialty

Plastic and Reconstructive SurgeryAlso: Maxillofacial Surgery

Education

Harvard Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty Foundation 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1508021171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 20-2060",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-6022",
            "fax_number": "312-695-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 20-2060",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-6022",
            "fax_number": "312-695-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARCO",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036121419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12576013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Ellis
• Jessica Ellis, MA
• Kathleen Mary Ellis
• Kathryn M Ellis, APRN, DNP, PMHNP-BC
• Lauren Katherine Ellis, APN
• Nia Imani Ellis
• Nicola Ellis, LCSW
• Nicole Ellis, LPC
• Rebecca Ellis, LPC
• Sue Ellis

• All providers in Chicago, IL
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.