Individual provider Active NPI

Emma Ellis

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1548836158
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3323 Circle Brook Dr Apt E
Roanoke, VA 24018-8253
Phone
(703) 969-8633
NPI assigned
Jun 3, 2021
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3323 Circle Brook Dr Apt E
Roanoke, VA 24018-8253

Mailing address

6618 Birchleigh Way
Alexandria, VA 22315-3644
Phone (703) 969-8633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20220427003316 DC Practitioner - Physician Assistant 1658768361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Braun Dermatology and Skin Cancer Center, PCGroup PAC ID 5395788210, 9 clinicians

Practice addresses (Care Compare)

3301 New Mexico Ave NW
Suite 301
Washington, DC 20016-3603
Phone (202) 293-7618

Merit-based Incentive Payment System (MIPS)

Final score
94.71 of 100Reported as group
Quality
100
Improvement activities
40
Cost
82.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1548836158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6618 BIRCHLEIGH WAY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223153644",
            "telephone_number": "703-969-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 CIRCLE BROOK DR APT E",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188253",
            "telephone_number": "703-969-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.