Ellie Kelepouris, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD038124L Issued in PA

Practice address

216 N. Broad St.
5TH Floor
Philadelphia, PA 19102

Phone

(215) 762-1147

Fax

(215) 762-1904

NPI assigned

Oct 6, 2005

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

Other identifiers 1

Other names 1

• Ellie Tzarnas Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

NephrologyAlso: Internal Medicine

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Buttonwood Dialysis Dialysis facility, Philadelphia, PA, CCN 392788
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Penn-Medical Group

  • Gastroenterology Physician
  • Lancaster, PA
  • NPI 1043670805
  Medicare reassignment Care Compare group NPD
• Drexel University

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Drexel University

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1871607929
  NPD
• University of Penn - Medical Group

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1629181912
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  NPD (past)

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1881968774

  Dialysis facility

  Care Compare affiliation Name & address match
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Presbyterian Medical Center of the University of Pennsylvania Health S

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1245207521
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1790773547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST.",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N. BROAD ST.",
            "address_2": "5TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-1147",
            "fax_number": "215-762-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELEPOURIS",
        "first_name": "ELLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD038124L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008593700002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLIE",
            "last_name": "TZARNAS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tynae Dominique Keith
• Keiths Legacy Home Care LLC
• Janet Adeola Korede Keku-Lewis, MD
• Elaine Kelbick, MD
• Jelte Kelchtermans, M.D.
• Quinn Colleen Kelleher, PHARMD
• Thomas J. Kelleher, OD
• Natalie Marie Keller-Bertolino, LCSW
• Bari Keller
• Cory J Keller, D.O.

• Nephrology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.