Individual provider Active NPI

Ella Viktorovna Farricielli, M.D.

  • Internal Medicine Physician
  • Waxahachie, TX
National Provider Identifier
1942399530
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N7920 Issued in TX
Practice address
505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128
Phone
(972) 923-1686
Fax
(972) 937-7731
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN10075 FL
Internal Medicine Physician 207R00000X N7920 TX Primary

Addresses

Primary practice location

505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128

Mailing address

505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128
Phone (972) 923-1686

Other identifiers 2

IdentifierTypeStateIssuer
8CR652OtherTXBCBSTX
280059101MedicaidTX

Other names 1

  • Dr. Ella Viktorovna Aksenova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20140310001952 SC Practitioner - Internal Medicine 8325224876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1006

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
79.17
Improvement activities
40
Cost
69.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN10075FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians of SC, LLC CurrentSince Oct 1, 2019 Accepting new patients
South Carolina Group Services, LLC CurrentSince Feb 20, 2017 Accepting new patients
Bon Secours St. Francis Xavier Hospital Inc. Past Accepting new patients
Roper Hospital, Inc Past Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1942399530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-937-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-937-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRICIELLI",
        "first_name": "ELLA",
        "middle_name": "VIKTOROVNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN10075",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8CR652",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280059101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLA",
            "last_name": "AKSENOVA",
            "middle_name": "VIKTOROVNA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.