Carolyn Ellis, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

DO2591 Issued in ME

Practice address

498 Essex St Ste 106
Bangor, ME 04401-3990

Phone

(207) 942-0669

NPI assigned

Jul 11, 2012

Last updated

Jan 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 ME

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

Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Penobscot Valley Dermatology PAGroup PAC ID 7315092541, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score

90.22 of 100Reported as group

Quality

85.35

Improvement activities

40

Cost

86.93

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Penobscot Valley Dermatology, P.a.

  • Specialist
  • Bangor, ME
  • NPI 1952536880

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1841555398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 ESSEX ST STE 106",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013990",
            "telephone_number": "207-942-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 ESSEX ST STE 106",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013990",
            "telephone_number": "207-942-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CAROLYN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ME",
            "license": "DO2591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Elamin Abbas Elkhedr
• Ellen J. Bentley, M.D., P.a.
• Amanda Elliott, ADCA
• Sara Elliott, LCPC
• Bonnie J Ellis
• Joan J Ellis
• Lee A Ellis, RN
• Chelsea Elston, CADC
• Embark Place LLC
• Amanda Leigh Emerson, AU.D.

• Dermatology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Dermatology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.