Catherine Elizabeth Ellis, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

317728 Issued in NY

Practice address

489 Atlantic Ave
Brooklyn, NY 11217-2985

Phone

(718) 332-4747

Fax

(718) 332-0414

NPI assigned

Apr 14, 2018

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

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic W Medical Care PLLCGroup PAC ID 2769897271, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Networks

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

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.

• Atlantic W Medical Care PLLC

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
  • NPI 1457968299

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• W Medical Care PC

  • Orthopaedic Surgery Physician
  • Brooklyn, NY
  • NPI 1659819522
  NPD (past)

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

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1508353640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172985",
            "telephone_number": "718-332-4747",
            "fax_number": "718-332-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CATHERINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-14",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "317728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Nancy Elliott
• Amanda D Ellis
• Anthony P Ellis, DPT
• Ashley Ellis
• Catherine Ellis
• Cynthia Marie Ellis, LCSW,CASAC
• Darnette Ann-Marie Ellis, LMSW
• Earl Anthony Ellis, MD
• Eugene Ellis, MD
• Gavin N Ellis

• Sports Medicine (Family Medicine) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Sports Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.