NPIMap

Individual provider Active NPI

Brigid Kathleen Ellis, D.O.

  • Nephrology Physician
  • Wyomissing, PA
National Provider Identifier
1992932339
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS015324 Issued in PA
Practice address
1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029
Phone
(610) 376-7365
Fax
(610) 376-1320
NPI assigned
Jun 12, 2009
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT012854 PA
Nephrology Physician 207RN0300X OS015324 PA Primary

Addresses

Primary practice location

1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029

Mailing address

1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029
Phone (610) 376-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729001327 PA Practitioner - Nephrology 4880810704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reading Nephrology, LTDGroup PAC ID 2062451578, 13 clinicians

Practice addresses (Care Compare)

1030 Reed Ave
Suite 114
Wyomissing, PA 19610-2039
Phone (610) 376-7365

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012854PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Nephrology, LTD Nephrology CurrentSince Jul 1, 2014 Accepting new patients

Locations

1030 Reed Ave
Ste 114
Wyomissing, PA 19610
Phone (610) 376-7365

220 N Park Rd
Wyomissing, PA 19610

Interoperability endpoints

  • Direct secure messaging: drellis@readingnephrology.medentdirect.com

Organizations & group practices 1

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 8

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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1992932339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 REED AVENUE",
            "address_2": "SUITE 114",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102029",
            "telephone_number": "610-376-7365",
            "fax_number": "610-376-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 REED AVENUE",
            "address_2": "SUITE 114",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102029",
            "telephone_number": "610-376-7365",
            "fax_number": "610-376-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "BRIGID",
        "middle_name": "KATHLEEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT012854",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "OS015324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.