Individual provider Active NPI

Joseph William Ellender IV, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1609103738
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2716 Ashton Dr
Wilmington, NC 28412-2489
Phone
(910) 332-3800
Fax
(910) 251-0421
NPI assigned
Nov 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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 Primary

Addresses

Primary practice location

2716 Ashton Dr
Wilmington, NC 28412-2489

Mailing address

325 Western Blvd
Jacksonville, NC 28546-6341
Phone (910) 577-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20110203000350 NC Practitioner - Physician Assistant 9739369034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

2716 Ashton Dr
Wilmington, NC 28412-2489
Phone (910) 332-3800

3787 Shipyard Blvd
Wilmington, NC 28403-6148
Phone (910) 332-3800

6019 Oleander Dr
Suite 200
Wilmington, NC 28403-4813
Phone (910) 790-9714

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

8115 Market St
Suite 108
Wilmington, NC 28411-8429
Phone (910) 332-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Nov 5, 2018 Accepting new patients
Emergeortho PA Physician Assistant CurrentSince Nov 5, 2018 Accepting new patients

Locations

1168 E Cutlar Crossing
Leland, NC 28451
Phone (910) 604-2414

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

6019 Oleander Dr
Ste 200
Wilmington, NC 28403
Phone (910) 790-9714

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

Interoperability endpoints

  • Direct secure messaging: jellender1245560@direct.novanthealth.org
  • Direct secure messaging: joseph.ellender.1@847.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1609103738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466341",
            "telephone_number": "910-577-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 ASHTON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122489",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENDER",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-10",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.