Active NPI
Brigid Kathleen Ellis, D.O.
- Nephrology Physician
- Wyomissing, PA
National Provider Identifier
1992932339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- OS015324
- Practice address
- 1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029 - Phone
- (610) 376-7365
- Fax
- (610) 376-1320
- NPI assigned
- Jun 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102933835-0001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
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
Practice addresses (Care Compare)
1030 Reed Ave
Suite 114
Wyomissing, PA 19610-2039
Phone (610) 376-7365
Hospital & facility affiliations
- Reading Hospital
- Penn State Health St. Joseph
- The Reading Hospital and Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT012854 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reading Nephrology, LTD | Nephrology | Current | Accepting new patients |
Locations
220 N Park Rd
Wyomissing, PA 19610
1030 Reed Ave
Ste 114
Wyomissing, PA 19610
Phone (610) 376-7365
Interoperability endpoints
- 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 and National Provider Directory roles.
-
- Nephrology Physician
- Wyomissing, PA
- NPI 1558426833
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Wyomissing, PA
- NPI 1093875270
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1467007112
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1669530069
-
- General Acute Care Hospital
- Reading, PA
- NPI 1699734665
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102933835-0001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.