Active NPI
Jason A. Ellis, M.D.
- Neurological Surgery Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 260313-1
- Practice address
- 130 East 77TH Street
Dept. of Neurosurgery, Black Hall, Third Floor
New York, NY 10075 - Phone
- (212) 434-3900
- Fax
- (212) 434-3899
- NPI assigned
- May 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 75452 | GA | |
| Neurological Surgery Physician | 207T00000X | 260313-1 | NY | Primary |
Addresses
Primary practice location
130 East 77TH Street
Dept. of Neurosurgery, Black Hall, Third Floor
New York, NY 10075
Mailing address
130 East 77TH Street
Dept. of Neurosurgery, Black Hall, Third Floor
New York, NY 10075
Phone (212) 434-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Columbia University College of Physicians and Surgeons, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Laminectomy or laminotomy (partial removal of spine bones) | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75452 | GA | MD | Neurological Surgery Physician |
| 260313-1 | NY | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore - Lij Medical PC | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Neurological Surgery | Current | Accepting new patients |
| Maimonides Medical Center | Current | Accepting new patients | |
| Lenox Hill Hospital | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
130 E 77th St
Fl Third
New York, NY 10075
Phone (212) 434-3900
130 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-3691
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- jasonellis@mai.allscriptsdirect.net
- jellis67099@northwell.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.
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
Neurological Surgery
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1093777492
-
dba NSLIJ Medical In Queens
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
- General Acute Care Hospital
- New York, NY
- NPI 1477616571
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1477616571
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629244884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 EAST 77TH STREET",
"address_2": "DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10075",
"telephone_number": "212-434-3900",
"fax_number": "212-434-3899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 EAST 77TH STREET",
"address_2": "DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10075",
"telephone_number": "212-434-3900",
"fax_number": "212-434-3899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JASON",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-07",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "GA",
"license": "75452",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NY",
"license": "260313-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.