Elisheva Ellenberg

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704311157 Issued in MI

Practice address

11800 E 12 Mile Rd
Warren, MI 48093-3472

Phone

(773) 517-7931

NPI assigned

May 12, 2020

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

Nurse Practitioner

Education

Oakland Univ, William Beaumont School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eellenberg1126148@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.

• Henry Ford Health Macomb-Oakland Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Macomb Oakland Hospital

  • Nurse Practitioner
  • Warren, MI
  • NPI 1578696092
  Medicare reassignment
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1831711936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16986 HILTON ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751915",
            "telephone_number": "773-517-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "773-517-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "ELISHEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704311157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Elia, M.S.
• Lord Ameer Elia I
• Elite Home Help Agency LLC
• Elite Rehab
• Elite Technical Care LLC
• Megan Ellery, LPC
• Dakota Elliott
• Emily Camille Ellis, FNP-BC
• Anthony Ells
• Melissa M Elmore, LLMSW

• Family Nurse Practitioner in Warren, MI
• Providers in Warren, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.