Individual provider Active NPI

Michael Ellis, M.D.

  • Infectious Disease Physician
  • Toledo, OH
National Provider Identifier
1871564617
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
35.125469 Issued in OH
Practice address
3125 Transverse Dr
Toledo, OH 43614-8008
Phone
(419) 383-3780
Fax
(419) 383-3338
NPI assigned
Jan 30, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD32787 DC
Infectious Disease Physician 207RI0200X 35.125469 OH Primary

Addresses

Primary practice location

3125 Transverse Dr
Toledo, OH 43614-8008

Mailing address

3355 Glendale Ave FL 3
Toledo, OH 43614-2426
Phone (419) 383-5322

Other identifiers 1

IdentifierTypeStateIssuer
0133740MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150715002061 OH Practitioner - Infectious DiseasePractitioner - Internal Medicine 4981876570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3578

3125 Transverse Dr
Toledo, OH 43614-8008
Phone (419) 383-5000

3333 Glendale Ave
Toledo, OH 43614-2426
Phone (419) 383-5550

3355 Glendale Ave
Toledo, OH 43614-2426
Phone (419) 383-5614

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
69.17
Promoting interoperability
99
Improvement activities
40
Cost
75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.125469OHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University of Ohio at Toledo Current Accepting new patients
University of Toledo Physicians LLC CurrentSince Aug 1, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L4189
Columbus, OH 43260

2100 W Central Ave
Ste 2
Toledo, OH 43606

3000 Arlington Ave
#1186
Toledo, OH 43614
Phone (419) 383-6966

3125 Transverse Dr
Toledo, OH 43614
Phone (419) 383-3771

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

3355 Glendale Ave
Fl 3
Toledo, OH 43614
Phone (419) 383-7100

Interoperability endpoints

  • Direct secure messaging: mellis24522@direct.utoledo.edu

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Toledo Medical CenterToledo, OH, CCN 360048 Hospital Corporate Officer (14.29%) Aug 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871564617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE FL 3",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-5322",
            "fax_number": "419-383-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 TRANSVERSE DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436148008",
            "telephone_number": "419-383-3780",
            "fax_number": "419-383-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "DC",
            "license": "MD32787",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35.125469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.