Provider Type Icon

DR. SHANE THOMAS ELLIS M.D. NPI 1366701153


NPI Information

NPI: 1366701153
Provider Name: DR. SHANE THOMAS ELLIS, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Organization: ALLINA HEALTH SYSTEM

PECOS Registration: Yes

Address:
2925 CHICAGO AVE
MINNEAPOLIS, MN
ZIP 55407
Phone: (612) 863-4000
Get Directions

DR. Shane Thomas Ellis, M.D. is an internal medicine in Minneapolis, MN with 12 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. Shane Thomas Ellis, M.D. NPI is 1366701153. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

2925 CHICAGO AVE
MINNEAPOLIS, MN
ZIP 55407
Phone: (612) 863-4000

The NPI 1366701153 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 enumeration date for this NPI number is 5/14/2012 and was last updated on 3/11/2021.


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 Medicine57547MINNESOTAYes
2208D00000XGeneral Practice57547MINNESOTANo
3390200000XStudent in an Organized Health Care Education/Training ProgramNo

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.