Active NPI
John E Ellis, O.D.
- Optometrist
- Connellsville, PA
National Provider Identifier
1962465971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001091
- Practice address
- 619 E Crawford Ave
Connellsville, PA 15425-2102 - Phone
- (724) 628-1370
- Fax
- (724) 628-7314
- NPI assigned
- Apr 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001091 | PA | Primary |
Addresses
Primary practice location
619 E Crawford Ave
Connellsville, PA 15425-2102
Mailing address
619 E Crawford Ave
Connellsville, PA 15425-2102
Phone (724) 628-1370
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009205 | Other | PA | DORAL |
| 397414 | Other | PA | ADVANTRA |
| 397414 | Other | PA | HEALTH ASSURANCE |
| P00230647 | Other | PA | UNITED HEALTHCARE |
| 1451095 | Other | PA | UMWA |
| 0014138740003 | Medicaid | PA | |
| 137989 | Other | PA | EYEMED |
| EL715656 | Other | PA BLUE SHIELD | |
| 123681 | Other | PA | AETNA |
| 03770 | Other | PA | GATEWAY |
| 118173 | Other | PA | UNISON |
| 207741 | Other | PA | UPMC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031105000698 | PA | Practitioner - Optometry | 4981516044 | Practice locations: Connellsville, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
619 E Crawford Ave
Connellsville, PA 15425-2172
Phone (724) 628-1370
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 194 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E. Ronald Salvitti, M.D., Inc. | Past | Accepting new patients | |
| E. Ronald Salvitti, M.D., Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Washington, PA
- NPI 1578567954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393977600000",
"number": "1962465971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 E CRAWFORD AVE",
"city": "CONNELLSVILLE",
"state": "PA",
"postal_code": "154252102",
"telephone_number": "724-628-1370",
"fax_number": "724-628-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 E CRAWFORD AVE",
"city": "CONNELLSVILLE",
"state": "PA",
"postal_code": "154252102",
"telephone_number": "724-628-1370",
"fax_number": "724-628-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-10",
"last_updated": "2014-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001091",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL",
"identifier": "0009205",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVANTRA",
"identifier": "397414",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ASSURANCE",
"identifier": "397414",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "P00230647",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1451095",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0014138740003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "137989",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA BLUE SHIELD",
"identifier": "EL715656",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "123681",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "03770",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "118173",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC",
"identifier": "207741",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Connellsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.