Active NPI
Scott Ellner, DO
- Surgery Physician
- Hartford, CT
National Provider Identifier
1760484182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 043507
- Practice address
- 1000 Asylum Ave
4320
Hartford, CT 06105-1770 - Phone
- (860) 714-5237
- Fax
- (860) 714-8096
- NPI assigned
- Aug 15, 2005
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 043507 | CT | Primary |
Addresses
Primary practice location
1000 Asylum Ave
4320
Hartford, CT 06105-1770
Mailing address
1000 Asylum Ave
4320
Hartford, CT 06105-1770
Phone (860) 714-5237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001435074 | Medicaid | CT |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043507 | CT | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1760484182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 ASYLUM AVE",
"address_2": "4320",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051770",
"telephone_number": "860-714-5237",
"fax_number": "860-714-8096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 ASYLUM AVE",
"address_2": "4320",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051770",
"telephone_number": "860-714-5237",
"fax_number": "860-714-8096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLNER",
"first_name": "SCOTT",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "043507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001435074",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.