Individual provider Active NPI

Jamie Ellis, MD

  • Family Medicine Physician
  • Lawrence, MA
National Provider Identifier
1891225561
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
272113 Issued in MA
Practice address
34 Haverhill St
Lawrence, MA 01841-2884
Phone
(978) 686-0090
Fax
(978) 686-4137
NPI assigned
Jun 15, 2017
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 272113 MA Primary

Addresses

Primary practice location

34 Haverhill St
Lawrence, MA 01841-2884

Mailing address

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210621003149 MA Practitioner - Family Practice 8022389204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

370 Merrimack St
Lawrence, MA 01843-1788
Phone (978) 557-8800

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Holy Family Hospital Hospital, Methuen, MA, CCN 220080

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince May 12, 2024 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince May 12, 2024 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients
Community Medical Associates, Inc. Family Medicine CurrentSince Jun 9, 2021 Accepting new patients
Pentucket Medical Associates, LLC Family Medicine Current Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

370 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

34 Haverhill St
Lawrence, MA 01841

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

Interoperability endpoints

  • Direct secure messaging: ellis.jamie.pma@direct.partners.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891225561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090",
            "fax_number": "978-686-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090",
            "fax_number": "978-686-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JAMIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "272113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.