Individual provider Active NPI

Sarah Peyton Ellis, MD

  • Obstetrics & Gynecology Physician
  • Wheat Ridge, CO
National Provider Identifier
1821096447
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38350 Issued in CO
Practice address
3555 Lutheran Pkwy
Suite 150
Wheat Ridge, CO 80033-6021
Phone
(303) 940-1867
Fax
(303) 940-1894
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 38350 CO Primary

Addresses

Primary practice location

3555 Lutheran Pkwy
Suite 150
Wheat Ridge, CO 80033-6021

Mailing address

3555 Lutheran Pkwy
Suite 150
Wheat Ridge, CO 80033-6021
Phone (303) 940-1867

Other identifiers 3

IdentifierTypeStateIssuer
66308321MedicaidCO
04012365MedicaidCO
160057521OtherCORAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20100924000416 CO Practitioner - Obstetrics/Gynecology 9739205998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Colorado School of Medicine, Denver, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN AffiliatesGroup PAC ID 6608765060, 66 clinicians

Practice addresses (Care Compare)

2801 Youngfield St
Suite 200
Golden, CO 80401-2202
Phone (303) 940-1867

Hospital & facility affiliations

  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38350COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Affiliates Obstetrics & Gynecology CurrentSince Jan 15, 2019 Accepting new patients
Intermountain Front Range, Inc. Past Accepting new patients

Locations

7200 S Alton Way
Ste A100
Centennial, CO 80112
Phone (303) 730-2229

2801 Youngfield St
Ste 200
Lakewood, CO 80401
Phone (303) 432-9939

Interoperability endpoints

  • Direct secure messaging: sarah.ellis.1@8558.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1821096447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY",
            "address_2": "SUITE 150",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336021",
            "telephone_number": "303-940-1867",
            "fax_number": "303-940-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY",
            "address_2": "SUITE 150",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336021",
            "telephone_number": "303-940-1867",
            "fax_number": "303-940-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SARAH",
        "middle_name": "PEYTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "38350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66308321",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04012365",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "160057521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.