Tanya Shawn Ellis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26544 Issued in AZ

Practice address

6320 W Union Hills Dr Ste 2800B
Glendale, AZ 85308-1380

Phone

(623) 322-4991

Fax

(623) 322-9568

NPI assigned

Mar 8, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Valley Family Medicine PCGroup PAC ID 2668462201, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: tanya.ellis.p1@direct.nvfm.nextgenshare.com

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.

• North Valley Family Medicine PC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1750344347
  Medicare reassignment Care Compare group NPD

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

• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1700854676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE 2800B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081380",
            "telephone_number": "623-322-4991",
            "fax_number": "623-322-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE 2800B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081380",
            "telephone_number": "623-322-4991",
            "fax_number": "623-322-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TANYA",
        "middle_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "26544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "AZ0720030",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelique Ellis
• Diane Carol Ellis, LCSW
• John William Ellis, D.O.
• Nicholas Daniel Ellis, PHARMD
• Renee M Ellis
• Vonda Lanete Ellis
• Alexandria Louise Ellsworth, CF-SLP
• Charly Ellsworth, PHARMD
• Ellsworthbeckham PLLC (OnCall Dental)
• Taegan Elmer, LPC, MC

• Family Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.