Individual provider Active NPI

Ariana M Ellis, MD

  • Dermatology Physician
  • Concord, NC
National Provider Identifier
1629605829
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2024-01113 Issued in NC
Practice address
335 Penny LN
Concord, NC 28025-1221
Phone
(704) 784-5901
NPI assigned
Mar 26, 2020
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2024-01113 NC Primary

Addresses

Primary practice location

335 Penny LN
Concord, NC 28025-1221

Mailing address

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5901

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903002337 NC Practitioner - Dermatology 2264857382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of the CarolinasGroup PAC ID 3678514759, 24 clinicians

Practice addresses (Care Compare)

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5907

Merit-based Incentive Payment System (MIPS)

Final score
85.93 of 100Reported as group
Quality
69.47
Promoting interoperability
100
Improvement activities
40
Cost
83.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision21
Removal of skin lesions311
Removal or shaving of skin growth1-10
Skin biopsy104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-01113NCMDDermatology Physician
8692WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of the Carolinas Dermatology CurrentSince Aug 30, 2024 Accepting new patients

Locations

335 Penny Ln
Concord, NC 28025
Phone (704) 784-5901

Interoperability endpoints

  • Direct secure messaging: aellis@directaddress.net

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1629605829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ARIANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2024-01113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.