Ellman Rehab Associates PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3092 Issued in TX

Legal business name

ELLMAN REHAB ASSOCIATES PA

Practice address

2692 N Galloway #402
Mesquite, TX 75150-6360

Phone

(972) 682-3909

Fax

(972) 682-9289

NPI assigned

Apr 2, 2007

Last updated

Feb 6, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Gary Ellman, MDNPI 1245339977

Title

Pysician Owner

Phone

(972) 682-3909

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Gary Ellman, MD

  • Specialist
  • Mesquite, TX
  • NPI 1245339977
  Authorized official Same address or phone
• Ivan Figueroa, MD

  • Physical Medicine & Rehabilitation Physician
  • Dallas, TX
  • NPI 1851595359
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1912028804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850304",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751850304",
            "telephone_number": "972-682-3909",
            "fax_number": "972-682-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2692 N GALLOWAY #402",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506360",
            "telephone_number": "972-682-3909",
            "fax_number": "972-682-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLMAN REHAB ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "ELLMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PYSICIAN OWNER",
        "authorized_official_telephone_number": "972-682-3909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0074QG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "J3092",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12249902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "00Y500",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.