Patrick Boone Ellis, D.O.

Primary specialty

SpecialistTaxonomy code 174400000X

License

3351 Issued in OK

Practice address

226 W Gray St Ste 214
Norman, OK 73069-7132

Phone

(405) 701-5666

Fax

(405) 701-5667

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Healthback Home Health of Norman, Inc.

  • Home Health Agency
  • Norman, OK
  • NPI 1639461650
  NPD (past)
• Joseph M. Ripperger, M.D. PLLC

  • Psychiatry Physician
  • Norman, OK
  • NPI 1952437550
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1982636809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 24TH AVE S.W.",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730695106",
            "telephone_number": "405-701-5666",
            "fax_number": "405-701-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 W GRAY ST STE 214",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730697132",
            "telephone_number": "405-701-5666",
            "fax_number": "405-701-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "PATRICK",
        "middle_name": "BOONE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "3351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138180B",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "405-701-5667",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "226 W Gray St Ste 214",
            "city": "Norman",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730697132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Elliott
• Bobby L Elliott, DO
• Hannah Elliott
• Rebecca Elliott
• Brian Thomas Ellis, MD
• Keelen D Ellison
• Shayla Ellison, RBT
• Ahlaam Elmi
• Rayele Nicole Elmore, BHCMI CPRSS
• Augusta Anne Elvik, LPC

• Specialist in Norman, OK
• Providers in Norman, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.