Leslie R Ellis, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

35733 Issued in KY

Practice address

4123 Dutchmans LN Ste 301
Louisville, KY 40207-4721

Phone

(502) 896-2500

Fax

(502) 896-2527

NPI assigned

Mar 14, 2006

Last updated

Sep 14, 2021By the provider in NPPES

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 4

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jelfarra131514@direct.nortonhealthcare.org
• Direct secure messaging: lellis12577@direct.nortonhealthcare.org

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.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762
  Medicare reassignment NPD
• Norton Children's Medical Group, LLC

  dba Norton Children's Behavioral and Mental Health

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• Norton Childrens Medical Group, LLC

  dba Norton Children's Medical Group

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  IN, Neonatal-Perinatal Medicine

  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Orthopaedic Surgery of the Spine Physician
  • Louisville, KY
  • NPI 1437382074

  Neonatal-Perinatal Medicine

  NPD
• Community Medical Associates, Inc.

  dba Norton Community Medical Associates

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Norton Children's Medical Group, LLC

  dba Norton Children's Neonatology Specialists

  • Neonatal-Perinatal Medicine Physician
  • Louisville, KY
  • NPI 1144862301
  NPD
• Norton Children's Medical Group, LLC

  dba Norton Children's Radiologists

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Neonatal Intensive Care Experts PLLC

  • Neonatal-Perinatal Medicine Physician
  • Louisville, KY
  • NPI 1962596866
  NPD (past)
• Norton Hospitals, Inc

  dba Norton Hospital

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1891799227
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1679542765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-272-5395",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN STE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074721",
            "telephone_number": "502-896-2500",
            "fax_number": "502-896-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LESLIE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "35733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT- KCNS",
            "identifier": "50035433",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64067267",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM- KCNS",
            "identifier": "000000744501",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200439570",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jelfarra131514@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "4123 Dutchmans Ln",
            "address_2": "Suite 301",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "4123 Dutchmans Ln",
            "address_2": "Suite 301",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jill Ellis
• Julie T. Ellis, M.D.
• Kaitlyn Christine Ellis
• Keidra Ellis, NURSE PRACTITIONER
• Laura Ellis, OTR/L
• Misty D Ellis, APRN
• Morgan Ellis
• Porsha Ellis
• Robert Ellsworth Ellis, M.D.
• Rudy John Ellis Jr., MD

• Neonatal-Perinatal Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neonatal-Perinatal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.