Mark I Ellen, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME145025 Issued in FL

Practice address

2108 Alexander Cir NE
Atlanta, GA 30326-1246

Phone

(214) 952-3501

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mellen@ocp.emadirect.md

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.

• Johns Hopkins University

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Baltimore, MD
  • NPI 1275180424

  Multi-Specialty

  Medicare reassignment NPD
• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549

  Multi-Specialty

  Medicare reassignment NPD
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774

  Multi-Specialty

  NPD
• Johns Hopkins University

  • Physical Medicine & Rehabilitation Physician
  • Lutherville, MD
  • NPI 1831195502

  Multi-Specialty

  NPD
• Physical Medicine Center

  • Physical Medicine & Rehabilitation Physician
  • Marietta, GA
  • NPI 1588767750

  Multi-Specialty

  NPD (past)
• Shilo Enterprises PC

  • Chiropractor
  • Marietta, GA
  • NPI 1215398557

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1720181951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10435 SE 170TH PL",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918998",
            "telephone_number": "352-630-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 ALEXANDER CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261246",
            "telephone_number": "214-952-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEN",
        "first_name": "MARK",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MA06361300",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "MD051555L",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NC",
            "license": "2005-01826",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "G71376",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "ME145025",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME145025",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "50578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Vo Elkins, OT002516
• David Elkon, MD
• Martha L Elks, MD
• Laura Degler Elledge, NP-C
• Ellen M Benson LLC
• Christina Ellenberg, RD, LDN, CSCS
• Abraham Ellenbogen
• Daniel P Eller, M.D.
• Tedd Vincent Ellerbrock, M.D.
• Nicole P Ellerine, M.D.

• Physical Medicine & Rehabilitation Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.