Linda Suzanne Ellis, MD

Primary specialty

Pediatric Pathology PhysicianTaxonomy code 207ZP0213X

License

S9678 Issued in TX

Practice address

4845 Alameda Ave
El Paso, TX 79905-2705

Phone

(915) 215-4956

Fax

(915) 215-4770

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Linda Suzanne Ellis-Lasky Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Children'S Specialists of San Diego, Inc. (CSSD)

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1801959127
  NPD (past)
• St Louis University

  • Optician
  • Saint Louis, MO
  • NPI 1487869863
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1780630913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051613",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052705",
            "telephone_number": "915-215-4956",
            "fax_number": "915-215-4770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-4956",
            "fax_number": "915-215-4770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Transmountain Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799113602",
            "country_code": "US",
            "telephone_number": "915-215-4956",
            "fax_number": "915-215-4770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-966-5944",
            "fax_number": "858-966-8087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LINDA",
        "middle_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A100038",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "CA",
            "license": "A100038",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "TX",
            "license": "S9678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "ELLIS-LASKY",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ammar Fadlalla Eljack, MD
• Ezra Samuel Elkayam, MD
• Gregory C. Elkins, MD
• Kaisa Elliott
• John L Ellis II, OD
• Mariah Alyss Ellis
• Sarah Michelle Ellis, FNP-C
• Steven Lee Ellis, D.O.
• Patricia E Ellison, OTR
• Marc Ellman, M.D.

• Pediatric Pathology Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.