William D Ellis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD2015-0028 Issued in NM

Practice address

8300 Constitution Ave NE
PMG Emergency Medicine
Albuquerque, NM 87110-7613

Phone

(505) 291-2122

Fax

(505) 291-2979

NPI assigned

Mar 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Emergency Medicine

Education

Wayne State University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Physicians of Genesee County PLLCGroup PAC ID 9830345677, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Merit-based Incentive Payment System (MIPS)

Final score

97.83 of 100Reported as group

Quality

88.63

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wellis1126180@direct.hfhs.org

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.

• Emergency Medicine Physicians of Genesee County, PLLC

  • Emergency Medicine Physician
  • Grand Blanc, MI
  • NPI 1275899171
  Medicare reassignment Care Compare group NPD
• Observation Medicine Group PLLC

  • Emergency Medicine Physician
  • Grand Blanc, MI
  • NPI 1194084111
  Medicare reassignment NPD

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

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1790050128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PRESBYTERIAN HEALTHCARE SERVICES - PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTITUTION AVE NE",
            "address_2": "PMG EMERGENCY MEDICINE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107613",
            "telephone_number": "505-291-2122",
            "fax_number": "505-291-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2015-0028",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "390200000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrica Diane Elliott
• Richard Elliott, RD
• Cheyenne Michelle Ellis
• Jermona Shantia Ellis, LNSW
• Moira Louise Ellis
• Crystal Ellison, LCSW
• Ja'Lyn Ellison
• Jasmine Nichole Ellison
• John Kenny Ellison, RN
• Katera Ellison

• Emergency Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.