Suzanne Ellis, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA-16387NP Issued in OH

Practice address

6252 Mahoning Ave
Austintown, OH 44515-2003

Phone

(330) 656-5911

Fax

(330) 656-5901

NPI assigned

Sep 11, 2014

Sex

Female

Sole proprietor

Yes

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 OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mves Boardman LLCGroup PAC ID 4688694722, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Merit-based Incentive Payment System (MIPS)

Final score

86.8 of 100Reported as group

Quality

79.54

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

89.13 of 100Reported as group

Quality

78.7

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mves Boardman LLC

  • Emergency Medicine Physician
  • Youngstown, OH
  • NPI 1205888237
  Medicare reassignment Care Compare group
• Mahoning Valley Emergency Specialists LLC

  • Emergency Medicine Physician
  • Youngstown, OH
  • NPI 1003869652
  Medicare reassignment NPD
• Mves Austintown LLC

  • Emergency Medicine Physician
  • Austintown, OH
  • NPI 1972555944
  Medicare reassignment NPD

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

• Mercy Health Youngstown LLC

  dba Mercy Health St Elizabeth Boardman Hospital

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1689075343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DARROW RD",
            "address_2": "SUITE 106",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365026",
            "telephone_number": "330-656-5911",
            "fax_number": "330-656-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6252 MAHONING AVE",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152003",
            "telephone_number": "330-656-5911",
            "fax_number": "330-656-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA-16387NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward M. Hobbs Jr DO Inc
• Dana Marie Eisenmann, RN
• Elaine's Health Services, Inc.
• Eileen Eldridge-Knyszek
• Tracy Elko, MA
• Victoria Natane Elsea, ACNPC-AG
• Matthew Emerick, LMT
• Breyaja Emerson, CMS
• Christina Ervin
• Shelby Esenwein

• Family Nurse Practitioner in Austintown, OH
• Providers in Austintown, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.

Verify at the official NPI Registry.