Max Evan Weintraub Ellithorpe, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

84286-20 Issued in WI

Practice address

600 Highland Ave
Madison, WI 53792-1465

Phone

(608) 263-6400

NPI assigned

Jan 11, 2022

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Male

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 WI

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

Psychiatry

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2023

Medicare assignment

May accept Medicare assignment

Group practices

Rogers Memorial Hospital IncorporatedGroup PAC ID 3476455809, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581
  Medicare reassignment Care Compare group NPD
• Milwaukee Behavioral Health LLC

  dba Granite Hills Hospital

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1497324115

  Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1982355020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921465",
            "telephone_number": "608-263-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLITHORPE",
        "first_name": "MAX",
        "middle_name": "EVAN WEINTRAUB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "84286-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ellis, LCSW, SAC-IT
• Richard L Ellis, MD
• Ashli L Ellison, NP
• Elizabeth Laurie Ellison, MS LMFT
• Matthew Christian Ellison, DPT
• Emily Clare Ellmann, MD
• Carlee Ellsworth
• Angeline Muriel Elmer, LPC
• Michelle Lynn Elmer, PA-C
• Theodore Frederick Elsaesser, M.D.

• Psychiatry Physician in Madison, WI
• Providers in Madison, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.