Active NPI
David S Ellis, MD
- Urology Physician
- Arlington, TX
National Provider Identifier
1760478150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- G3327
- Practice address
- 801 W I-20
Ste 1
Arlington, TX 76017-5851 - Phone
- (817) 784-0818
- Fax
- (817) 417-1100
- NPI assigned
- Sep 21, 2005
- Last updated
- Oct 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | G3327 | TX | Primary |
Addresses
Primary practice location
801 W I-20
Ste 1
Arlington, TX 76017-5851
Mailing address
PO Box 120549
Arlington, TX 76012-0549
Phone (817) 303-4521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128134704 | Medicaid | TX | |
| 128134702 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G3327 | TX | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Clinic of North Texas PLLC | Past | Accepting new patients | |
| Urology Associates of North Texas LLP | Urology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
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- NPI 1184131625
-
- Urology Physician
- Weatherford, TX
- NPI 1407849961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255046400000",
"number": "1760478150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 120549",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760120549",
"telephone_number": "817-303-4521",
"fax_number": "817-417-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W I-20",
"address_2": "STE 1",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760175851",
"telephone_number": "817-784-0818",
"fax_number": "817-417-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "DAVID",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2009-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "G3327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128134704",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128134702",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.