Kenneth A Ellenbogen, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

0101040591 Issued in VA

Practice address

1250 E Marshall St
Internal Medicine/Cardiology
Richmond, VA 23298-5051

Phone

(804) 828-7565

Fax

(804) 828-6082

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

Johns Hopkins University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
• Vcu Health Tappahannock Hospital Hospital, Tappahannock, VA, CCN 490084
• Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
• Community Memorial Hospital Hospital, South Hill, VA, CCN 490098
• Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

Merit-based Incentive Payment System (MIPS)

Final score

83.95 of 100Reported as group

Quality

69.91

Promoting interoperability

99

Improvement activities

40

Cost

77.42

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Community Memorial Hospital

  • General Acute Care Hospital
  • South Hill, VA
  • NPI 1336103738
  Care Compare affiliation
• HCA Health Services of Virginia Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1194762294
  Care Compare affiliation
• Riverside Middle Peninsula Hospital Inc

  • General Acute Care Hospital
  • Gloucester, VA
  • NPI 1528162534
  Care Compare affiliation
• Vcu Health Tappahannock Hospital

  • General Acute Care Hospital
  • Tappahannock, VA
  • NPI 1760580757
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1508966706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "INTERNAL MEDICINE/CARDIOLOGY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-7565",
            "fax_number": "804-828-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101040591",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "VA",
            "license": "0101040591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006027547",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Harry Ellen, MD
• Joseph Harry Ellen III, MD
• Rebecca M Ellen, PA
• Matthew Ellenberg, DO
• Russell C Ellenberg, MD
• Madeline Eller, MD
• Henry M Ellett, MD
• Michele Lynn Ellett, CPNP
• Susan E. Ellett, PH.D.
• Meghan Ellinghausen

• Clinical Cardiac Electrophysiology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Cardiac Electrophysiology Physician in Virginia

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