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ETHAN R ELLIS M.D. NPI 1316110208


NPI Information

NPI: 1316110208
Provider Name: ETHAN R ELLIS, M.D.
Classification: Internal Medicine - 207RC0001X
Entity Type: Individual

Specialization: Clinical Cardiac Electrophysiology

Organization: POUDRE VALLEY MEDICAL GROUP LLC

PECOS Registration: Yes

Address:
2121 E HARMONY RD
STE 100
FORT COLLINS, CO
ZIP 80528
Phone: (970) 221-1000
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Ethan R Ellis, M.D. is a clinical cardiac electrophysiology internal medicine in Fort Collins, CO with 18 years of experience. The provider is a field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. Ethan R Ellis, M.D. NPI is 1316110208. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduation Year:2006

The provider's business location address is:

2121 E HARMONY RD
STE 100
FORT COLLINS, CO
ZIP 80528-400
Phone: (970) 221-1000

The NPI 1316110208 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes (HCPCS:33208)
  • Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 4/11/2008 and was last updated on 3/28/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine235720MASSACHUSETTSNo
2207RC0001XInternal MedicineClinical Cardiac Electrophysiology27958NEBRASKANo
3207RC0000XInternal MedicineCardiovascular DiseaseDR.0053902COLORADONo
4207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyDR.0053902COLORADOYes
5207R00000XInternal MedicineDR.0053902COLORADONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
187529351MEDICAIDCOLORADO
2359522YLB8MEDICARE PINCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.