Nicole D Eller, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS12944 Issued in FL

Practice address

4451 Bayou Blvd
Pensacola, FL 32503-2601

Phone

(850) 416-7619

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 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

Specialty

Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hearth Hospice of Brunswick, LLC Hospice, Brunswick, GA, CCN 851531
• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Merit-based Incentive Payment System (MIPS)

Final score

76.36 of 100Reported as group

Quality

46.72

Promoting interoperability

99

Improvement activities

40

Cost

75.31

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Legacy Hospice Ga LLC

  • Community Based Hospice Care Agency
  • Brunswick, GA
  • NPI 1861158768

  W-2 Managing Employee

  CMS ownership
• Legacy Hospice Ga, LLC

  • Community Based Hospice Care Agency
  • Brunswick, GA
  • NPI 1477153492

  W-2 Managing Employee

  CMS ownership

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.

• Cooperative Healthcare Services Inc

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  GA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695

  FL

  Medicare reassignment NPD
• Floridian Hospitalist Services, LLC

  • Hospitalist Physician
  • Melbourne, FL
  • NPI 1831530385

  FL

  Medicare reassignment NPD
• Pensacola Hospitalist Physicians, LLC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1487254140

  FL

  Medicare reassignment NPD
• Floridian Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Crestview, FL
  • NPI 1992150007
  NPD
• Pensacola Hospitalist Physicians, LLC

  • Hospitalist Physician
  • Gulf Breeze, FL
  • NPI 1578164497
  NPD
• Southeast Georgia Health System, Inc.

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hearth Hospice of Brunswick, LLC

  • Community Based Hospice Care Agency
  • Brunswick, GA
  • NPI 1780215764

  Hospice

  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1679912562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032601",
            "telephone_number": "850-416-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS12944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ellen W McKnight MD PLLC
• Stephanie Ellerbe, PMHNP
• Christopher Ellington, BMBS
• Jonathan Neil Elliot Sr., MD
• Emily Jernigan Elliott, D.O.
• Mark Randall Elliott, M.D.

• All providers in Pensacola, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.