Amy Ellsworth

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024168309 Issued in VA

Practice address

1751 E Garry Ave
Santa Ana, CA 92705-5814

Phone

(877) 896-7350

NPI assigned

Sep 24, 2009

Sex

Female

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

Enrolled in UT, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of Utah School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthy Mindset Intl IncGroup PAC ID 4284046335, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.ellsworth@235818542825476.direct.elationemr.com

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.

• Healthy Mind Set Intl Inc

  dba Diabetes & Endocrine Treatment Specialists

  • Endocrinology, Diabetes & Metabolism Physician
  • Sandy, UT
  • NPI 1295351278
  Medicare reassignment Care Compare group NPD
• State of Utah

  dba Utah State Hospital

  • Psychiatric Hospital
  • Provo, UT
  • NPI 1811978620
  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• Health Clinics of Utah

  • State or Local Public Health Clinic/Center
  • Provo, UT
  • NPI 1982669982
  NPD
• Health Clinics of Utah-SLC

  • Family Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1871654459
  NPD
• University of Utah Adult Services

  dba Univ. of Utah Hospital General Surgery

  • Surgery Physician
  • Salt Lake City, UT
  • NPI 1548664352
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Advantmed Provider Network

  • General Practice Physician
  • Irvine, CA
  • NPI 1710409719
  NPD (past)

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1922332998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 E GARRY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055814",
            "telephone_number": "877-896-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 E GARRY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055814",
            "telephone_number": "877-896-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Elliott
• Wendy Marie Elliott, LCSW
• Ellis A. Ellis, RPH
• Matthew Ryan Ellis
• Carie Bailey Ellison, PA-C
• Tamar Elly, LCSW
• Afnan Gaber Elmaghrabi
• Elsa a Tekle MD Inc
• Eva Elsea
• Lobna Eltiby

• Family Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.