Ellie Jane Makoul, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012711 Issued in MI

Practice address

3770 Glenkerry CT
Portage, MI 49024-0700

Phone

(269) 329-2887

NPI assigned

Oct 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Southern Illinois University School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Michigan Pain Consultants PCGroup PAC ID 3173590957, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
• Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022
• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Southern Michigan Pain Consultants PC

  dba Axia Spine and Pain

  • Interventional Pain Medicine Physician
  • Portage, MI
  • NPI 1538119391
  Medicare reassignment Care Compare group
• Michigan Behavioral Consultants PC

  • Psychologist
  • Grand Rapids, MI
  • NPI 1336153220
  NPD (past)

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

• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation
• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Community Health Center of Branch County

  • General Acute Care Hospital
  • Coldwater, MI
  • NPI 1063471639
  Care Compare affiliation
• Ella E. M. Brown Charitable Circle

  dba Oaklawn Hospital

  • General Acute Care Hospital
  • Marshall, MI
  • NPI 1861475360
  Care Compare affiliation

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1790505683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240700",
            "telephone_number": "269-329-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOUL",
        "first_name": "ELLIE",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Folger Macdonald, PHD MSW
• Faith Elise Maddock, FNP-BC
• Analyse Madrigal
• Chester Maikoski
• Joshua Maikoski
• David Makowski
• Lisa Marie Makuch, PHD
• Ryan Malarney, DC
• Sarah Malarney, D.C.
• Mya Marie Mallad, LLMSW

• Physician Assistant in Portage, MI
• Providers in Portage, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.