Michele Ellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW18046 Issued in FL

Practice address

2008 Seagirt Blvd
Far Rockaway, NY 11691-2803

Phone

(718) 471-4881

NPI assigned

Aug 21, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CT, CA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Brightside Health, Inc.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1073072658

  FL

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1992139331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 NW WISK FERN CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864364",
            "telephone_number": "718-490-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 SEAGIRT BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912803",
            "telephone_number": "718-471-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MICHELE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "089294",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Elgendy, PT
• Lia Elipulikattu, MD
• Dmitriy Elkin, M.D.
• Heather Elkin
• Natalia Elkin, MD
• Michelle Ellis
• Elmont Rehab PT PC
• Irina Elnatanov
• Noha Elnoor Ahmed Elzaki, STUDENT
• Ngozi Emeagwali

• Clinical Social Worker in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.