Individual provider Active NPI

Laura Ellis, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1578904744
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33338633 Issued in NY
Practice address
1425 Madison Avenue, Box 1273
New York, NY 10029-6514
Phone
(650) 580-3624
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 833556 CA
Registered Nurse 163W00000X 26NR17280100 NJ
Registered Nurse 163W00000X RN657785 PA
Registered Nurse 163W00000X 22 657365 NY
Family Nurse Practitioner 363LF0000X 95001767 CA
Family Nurse Practitioner 363LF0000X 33338633 NY Primary

Addresses

Primary practice location

1425 Madison Avenue, Box 1273
New York, NY 10029-6514

Mailing address

1425 Madison Avenue, Box 1273
New York, NY 10029-6514
Phone (650) 580-3624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150727002064 NY Practitioner - Nurse Practitioner 8224342845 Reassigns benefits to 1 organization
I20180607003240 CA Practitioner - Nurse Practitioner 8224342845 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians
UCSF Dept of SurgeryGroup PAC ID 7719886373, 211 clinicians

Practice addresses (Care Compare)

400 Parnassus Ave
San Francisco, CA 94143-2202
Phone (415) 476-1000

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
92.74
Improvement activities
40
Cost
72.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR17280100NJMDRegistered Nurse
22 657365NYMDRegistered Nurse
RN657785PAMDRegistered Nurse
33338633NYMDFamily Nurse Practitioner
95001767CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince May 15, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 15, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 15, 2018 Accepting new patients
UCSF Dept of Surgery CurrentSince May 15, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2015 Accepting new patients
Regents of the University of California CurrentSince May 15, 2018 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince May 15, 2018 Accepting new patients
UCSF Pediatrics Associates CurrentSince May 15, 2018 Accepting new patients

Locations

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

150 E 42nd St
#10
New York, NY 10017

1425 Madison Ave
#1273
New York, NY 10029
Phone (650) 580-3624

Interoperability endpoints

  • Direct secure messaging: lellis98468@direct-ucsfmedicalcenter.org

Organizations & group practices 10

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 1

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": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1578904744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MADISON AVENUE, BOX 1273",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296514",
            "telephone_number": "650-580-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MADISON AVENUE, BOX 1273",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296514",
            "telephone_number": "650-580-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "833556",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR17280100",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN657785",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 657365",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001767",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33338633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.