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JAY T ELLIS PT DPT CSCS NPI 1811924012


NPI Information

NPI: 1811924012
Provider Name: JAY T ELLIS, PT, DPT, CSCS
Classification: Contractor - 171W00000X
Entity Type: Individual
Address:
3100 S WOODRUFF AVE
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 523-8879
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Jay T Ellis, PT, DPT, CSCS is a contractor in Idaho Falls, ID. The provider is a person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). Jay T Ellis, PT, DPT, CSCS NPI is 1811924012. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3100 S WOODRUFF AVE
IDAHO FALLS, ID
ZIP 83404-310
Phone: (208) 523-8879
Fax: (208) 523-0436

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.

  • Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • Manual (physical) therapy techniques to 1 or more regions, each 15 minutes (HCPCS:97140)
  • Application of ultrasound to 1 or more areas, each 15 minutes (HCPCS:97035)
  • Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes (HCPCS:97112)
  • Physical therapy evaluation (HCPCS:97001)
  • Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes (HCPCS:97530)

The enumeration date for this NPI number is 6/26/2006 and was last updated on 3/4/2011.


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
1171W00000XContractorRPT231IDAHOYes

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
11653264MEDICARE ID-TYPE UNSPECIFIEDIDAHO
2T0742OTHERIDAHOBLUE CROSS OF IDAHO
3804274500MEDICAIDIDAHO
4316942OTHERIDAHOBLUE SHIELD

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.