Individual provider Active NPI

Robert Michael Ellis, NP

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1902284599
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP7834 Issued in AZ
Practice address
2946 E Banner Gateway Drive
Gilbert, AZ 85234
Phone
(480) 256-3359
Fax
(480) 256-3359
NPI assigned
May 14, 2015
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP7834 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Drive
Gilbert, AZ 85234

Mailing address

2940 E Banner Gateway Drive
Gilbert, AZ 85234
Phone (480) 256-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923001599 AZ Practitioner - Nurse Practitioner 6608183637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP7834AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RHG of Arizona, PC CurrentSince Dec 23, 2024 Accepting new patients
Heritage Technologies, LLC CurrentSince Feb 1, 2017 Accepting new patients
Fountains Family Care, P.C. CurrentSince Jun 27, 2015 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Aug 17, 2020 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Aug 17, 2020 Accepting new patients

Locations

3930 S Alma School Rd
Ste 1
Chandler, AZ 85248
Phone (480) 726-6632

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

5656 S Power Rd
Ste 126
Gilbert, AZ 85295

20928 E Heritage Loop Rd
Ste 106
Queen Creek, AZ 85142

Organizations & group practices 5

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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1902284599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DRIVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DRIVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-3359",
            "fax_number": "480-256-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2025-08-07",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.