John S Ellis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OA05056 Issued in NJ

Practice address

691 Route 9 S
Millers Mall - Unit 4
Little Egg Harbor TWP, NJ 08087-4020

Phone

(609) 294-8144

Fax

(609) 812-5190

NPI assigned

Feb 27, 2006

Last updated

Feb 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parmelee Eye Care LLCGroup PAC ID 9830498435, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Parmelee Eye Care LLC

  dba Glynn Eye Care

  • Point of Service
  • Brunswick, GA
  • NPI 1447618525
  Medicare reassignment Care Compare group NPD
• Elite Eyecare Associates, PC

  dba Ellis Family Eyecare

  • Optometrist
  • Sicklerville, NJ
  • NPI 1083894943
  Medicare reassignment Authorized official
• Ellis' Family Eyecare, LLC

  • Optometrist
  • Little Egg Harbor TWP, NJ
  • NPI 1053598904
  Authorized official Same address or phone

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1871569244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 ROUTE 9 S",
            "address_2": "MILLERS MALL - UNIT 4",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874020",
            "telephone_number": "609-294-8144",
            "fax_number": "609-812-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 ROUTE 9 S",
            "address_2": "MILLERS MALL - UNIT 4",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874020",
            "telephone_number": "609-294-8144",
            "fax_number": "609-812-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA05056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "630717YCT",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Lee Duffield, PT,DPT
• Nicole K Edelman, LCSW
• Natalia N Effiong
• Steven Angelo Elias, MSPT
• Heidi M Elich, MS, RD
• Ellis' Family Eyecare, LLC
• Encore Preakness, Inc.
• Equilibrium Rehab, LLC
• Essence of Life Therapeutic Services LLC
• Etukuru MD PC

• Optometrist in Little Egg Harbor TWP, NJ
• Providers in Little Egg Harbor TWP, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.