NPIMap

Individual provider Active NPI

Richard Gregory Ellis, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1578095980
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
NYU Langone Medical Center
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5506
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 272709 MA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

NYU Langone Medical Center
550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402
Phone (617) 447-4907

Other practice location 1

330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (617) 449-5066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031002166 NY Practitioner - Physical Medicine and Rehabilitation 1052683547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Boston University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

  • Metropolitan Hospital Center Hospital, New York, NY, CCN 330199
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119
  • Metropolitan Hospital Center Inpatient rehabilitation facility, Nyc, NY, CCN 33T199

Merit-based Incentive Payment System (MIPS)

Final score
87.24 of 100Reported as group
Quality
63.63
Promoting interoperability
85
Improvement activities
40
Cost
73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Aug 19, 2024 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: rellis675165@nychhc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1578095980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "617-447-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NYU LANGONE MEDICAL CENTER",
            "address_2": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Mount Auburn St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021385502",
            "country_code": "US",
            "telephone_number": "617-449-5066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RICHARD",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "272709",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.