Dimitrius Dean Ellisen

Primary specialty

Health Information TechnicianTaxonomy code 247000000X

Practice address

8945 Golf Links Rd
Oakland, CA 94605-4124

Phone

(510) 317-1444

NPI assigned

Jan 24, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1902360902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8945 GOLF LINKS RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054124",
            "telephone_number": "510-317-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8945 GOLF LINKS RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054124",
            "telephone_number": "510-317-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISEN",
        "first_name": "DIMITRIUS",
        "middle_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Ellis
• Kim Ellis
• La Candra Virginia Ellis
• Patrick Ellis
• Senobia Frances Ellis
• Deone Ellison
• Kelsey Megan Ellison, CCC-SLP
• Mary Mae Ellison
• Tamara Abarca Ellsworth
• Russell Murray Ellyson, DO

• Health Information Technician in Oakland, CA
• Providers in Oakland, CA by specialty
• Health Information Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.