Miles Ellsworth, SRNA

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

4704295031 Issued in MI

Practice address

1000 N Oak Ave
Marshfield, WI 54449-5703

Phone

(715) 387-5511

NPI assigned

Nov 6, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

Merit-based Incentive Payment System (MIPS)

Final score

80.58 of 100Reported as group

Quality

55.5

Promoting interoperability

100

Improvement activities

40

Cost

71.46

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment Care Compare group NPD
• Beaver Dam Community Hospitals Inc

  dba Marshfield Medical Center - Beaver Dam Professional Services

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba MMC - Park Falls Outreach Services

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Professional Services

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• Memorial Hospital Inc

  dba Marshfield Medical Center - Neillsville

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Beaver Dam Community Hospitals Inc

  dba Hillside Unit Pharmacy (DME)

  • Pharmacy
  • Beaver Dam, WI
  • NPI 1295771780
  NPD
• Flambeau Hospital Inc

  dba Marshfield Medical Center - Park Falls

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Home Health

  • Home Health Agency
  • Rice Lake, WI
  • NPI 1326139049
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD
• Memorial Hospital Inc

  dba Memorial Hospital Inc Outreach Services

  • Clinic/Center
  • Neillsville, WI
  • NPI 1033701800
  NPD

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

• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Rural Acute Care Hospital
  • Marshfield, WI
  • NPI 1942749387
  Care Compare affiliation

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1841703402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16227 RAVINA WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341103269",
            "telephone_number": "231-633-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MILES",
        "credential": "SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "RN9418207",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704295031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahmoud Fouad Tawfik Elfeshawy, MD
• Abdou A Elhendy, MD, PHD
• Sabri Elamin Abbas Elkhidir, MD
• Sarah Ashley Elkins, DPT
• Parker Andrew Eller, DDS
• Carol Emanuel
• Heather J Endries, RD
• Krystle Jordan Endries, RD
• Kenneth E Engelhart, MD
• Regen Jeannine Erickson, RN

• Critical Care Medicine Registered Nurse in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Critical Care Medicine Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.