Avalon Elliott, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101024401 Issued in MI

Practice address

4350 Jackson Rd Ste 200
Ann Arbor, MI 48103-1889

Phone

(734) 761-2581

Fax

(734) 761-9540

NPI assigned

Apr 18, 2016

Last updated

Jul 12, 2019By the provider in NPPES

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

Other names 1

• Avalon Newsome Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Family and Internal Medicine- West Arbor

  • Family Medicine Physician
  • Ann Arbor, MI
  • NPI 1366599409
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Chelsea Inc

  dba Chelsea Hospital

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1922452762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 JACKSON RD STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031889",
            "telephone_number": "734-761-2581",
            "fax_number": "734-761-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AVALON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101024401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVALON",
            "last_name": "NEWSOME",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chandy Ellimoottil, MD
• Stephanie Stiff Ellimoottil, NP
• Sara Sadeghi Ellingwood, M.D.
• Amy E Elliott, RN, NP
• Anila Balakrishnan Elliott, MD
• Cynthia Elliott, PMHNP
• David Alan Elliott, M.D.
• Debbie Lynn Elliott, LPN
• Hallie Brick Elliott, CRNA
• Imani Elliott

• Family Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.