Individual provider Active NPI

Jay S. Ellis Jr., M.D.

  • Pain Medicine (Anesthesiology) Physician
  • San Antonio, TX
National Provider Identifier
1972535524
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
G6069 Issued in TX
Practice address
9819 Huebner Rd Ste 113
San Antonio, TX 78240-3253
Phone
(210) 692-0101
Fax
(210) 692-7615
NPI assigned
Jul 6, 2006
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X G6069 TX Primary
Anesthesiology Physician 207L00000X G6069 TX

Addresses

Primary practice location

9819 Huebner Rd Ste 113
San Antonio, TX 78240-3253

Mailing address

9819 Huebner Rd Ste 113
San Antonio, TX 78240-3253
Phone (210) 692-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120223000788 TX Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Pain Management 6709044639 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Pain Management
Education
Uniformed Services Uhs Fe Hebert School of Med, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allen Anesthesia AssociatesGroup PAC ID 2264477140, 94 clinicians

Practice addresses (Care Compare)

4510 Medical Ctr Dr
Suite 211
McKinney, TX 75069-1602
Phone (469) 541-1600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G6069TXMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Anesthesia Associates CurrentSince Jan 22, 2024 Accepting new patients
San Antonio Anesthesia Services PLLC Anesthesiology CurrentSince Jan 22, 2024 Accepting new patients
River City Pain Management, PLLC Anesthesiology CurrentSince Mar 15, 2016 Accepting new patients

Locations

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

9819 Huebner Rd
Ste 113
San Antonio, TX 78240
Phone (210) 692-0101

Interoperability endpoints

  • Direct secure messaging: ellis@rcpmp-tx.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1972535524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9819 HUEBNER RD STE 113",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403253",
            "telephone_number": "210-692-0101",
            "fax_number": "210-692-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9819 HUEBNER RD STE 113",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403253",
            "telephone_number": "210-692-0101",
            "fax_number": "210-692-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JAY",
        "middle_name": "S.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "G6069",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G6069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.