Patrick S Elliott, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5394015 Issued in WI

Practice address

49 N Walbridge Ave
Madison, WI 53714-3506

Phone

(608) 249-2555

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pediatric Dental Specialists of Madison LLC

  • Dentist
  • Madison, WI
  • NPI 1437310604
  NPD (past)
• Periodontal & Implant Specialists of Madison, LLC

  • Dentist
  • Madison, WI
  • NPI 1366614885
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679525976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 GILE DR",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535972661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 N WALBRIDGE AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537143506",
            "telephone_number": "608-249-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "PATRICK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5394015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33788400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hal Elliott, RN
• Jacob Joshua Elliott, MD
• Jamie Elliott, MD, PHD
• Mary Elizabeth Elliott, PHARMD
• Mekinzee Mae Elliott, MD
• Caitlin Ellis, LPC
• Christine Ellis, M.A., M.S., LPC
• Gayle M. Ellis
• Molly Ellis, RD, DC
• Rachel Ellis, LCSW, SAC-IT

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.