Lara M. Ellison, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036114549 Issued in IL

Practice address

2007 95TH Street
Suite 105
Naperville, IL 60563-7802

Phone

(630) 646-6920

Fax

(630) 646-6925

NPI assigned

Aug 11, 2006

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

Other identifiers 1

Electronic endpoints 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

Specialty

Family Practice

Education

Chicago College of Osteopathy, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Lisle, IL, CCN 147568
• Edward Hospital Hospital, Naperville, IL, CCN 140231
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Health Ventures

  • Family Medicine Physician
  • Naperville, IL
  • NPI 1427472042
  NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

• Copley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1295882561
  Care Compare affiliation
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Elmhurst Memorial Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation
• Residential Home Health Illinois, LLC

  • Home Health Agency
  • Lisle, IL
  • NPI 1336377365
  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1528079803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 95TH ST",
            "address_2": "STE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605637802",
            "telephone_number": "630-646-6920",
            "fax_number": "630-646-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 95TH STREET",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605637802",
            "telephone_number": "630-646-6920",
            "fax_number": "630-646-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "LARA",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036114549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114549 1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lellison15348@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2007 95th Street",
            "address_2": "Suite 105",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605637802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Eller
• Camille Ellimac-Raheem, LPC
• Ian Elliott, DDS
• Lori Lynn Ellis, FNP-BC
• Theodore Ellis, M.D.
• Crystal M Ellman, PT
• Jordan Elmer
• Ali Elrehaimy
• Caitlyn Elwart, ATC, OTC
• Aubrey Elwood, MS CF SLP

• Family Medicine Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.