SCOTT JACOB ELLIS MD PLLC (NPI# 1104424621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104424621 |
| Entity Type | Organization |
| Organization Name | SCOTT JACOB ELLIS MD PLLC |
| Practice Address |
523 E 72nd St Fl 5 New York NY 10021-4099 |
| Mailing Address |
Po Box 12184 Hauppauge NY 11788-0854 |
| Practice Telephone | 6467978305 |
| Practice Fax Number | 6467978515 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | SCOTT JACOB ELLIS (PRESIDENT) |
| Authorized Official Telephone | 6467978305 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
523 E 72ND ST FL 5 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10021-4099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720609175 | Haneen Qadourah | Student in an Organized Health Care Education/Training Program | Weillcornellinternalmedicineassociates, 505east70thstreet, Newyorkcity, NY 10021 | 2020-04-27 |
| 1114547080 | Mohd Omair Jamil | Pharmacist | 530 East 74th Street, 10281, New York, NY 10021 | 2020-04-21 |
| 1750915062 | Radoslav Jovanovic, Md and Kevin Jovanovic, Md | Obstetrics & Gynecology | 930 Fifth Avenue, Suite 3, New York, NY 10021 | 2020-02-25 |
| 1750915344 | Stacyann S Foster | Nurse Practitioner | 1305 York Avenue 2nd Floor, New York, NY 10021 | 2020-02-24 |
| 1477184547 | John Schipano | Pharmacist | Zitomer, 969 Madison Ave, New York, NY 10021 | 2020-01-28 |
| 1932741253 | Memorial Sloan Kettering Cancer Center | Pharmacy | 530 East 74 Street, Room 1101, New York, NY 10021 | 2019-10-09 |
| 1922656875 | Kouros Emami | Clinical Neuropsychologist | 525 East 71st St., 5th Floor, New York, NY 10021 | 2019-09-03 |
| 1083262539 | Uptown Surgical Services P.c | Clinic/Center | 111 East 71st Street, New York, NY 10021 | 2019-08-28 |
| 1316591209 | Siddiqi Medical P.C. | Internal Medicine | Archcare At Mary Manning Walsh Home, 1339 York Avenue, New York, NY 10021 | 2019-07-29 |
| 1942763602 | Alisha Bouzaher | Student in an Organized Health Care Education/Training Program | 439 East 71st, 1st Floor, New York, NY 10021 | 2019-04-10 |
| Find all providers in zip 10021 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881119303 | Ashraf Maher Fansa | Orthopaedic Surgery | Hospital for Special Surgery Academic Training, 535 E 70th St, New York, NY 10021 | 2017-08-05 |
| 1245330885 | Jessica B Gallina | Orthopaedic Surgery | 240 Central Park So, Ste 2-0, New York, NY 10019 | 2006-09-24 |
| 1902913791 | John G. Kennedy | Orthopaedic Surgery | 171 Delancey St Ste 210, New York, NY 10002-3411 | 2006-08-25 |
| 1730132432 | Steven C. Sheskier | Orthopaedic Surgery | 95 University Pl, 8th Floor, New York, NY 10003-4515 | 2006-05-17 |
| 1740727841 | Lauren Elizabeth Roberts | Orthopaedic Surgery | 535 East 70th Street, Hospital for Special Surgery, New York, NY 10021 | 2017-01-26 |
| 1508238320 | Haydee C Brown Md Pllc | Orthopaedic Surgery | 40 Park Ave Ste 1, New York, NY 10016-3467 | 2015-10-21 |
| 1295120756 | Javier Z. Guzman | Orthopaedic Surgery | 50 E 98th St, 9th Floor Box 1188, New York, NY 10029-6552 | 2015-04-01 |
| 1801949649 | Anne Holland Johnson | Orthopaedic Surgery | 535 E 70th St, New York, NY 10021 | 2007-01-18 |
| 1104902972 | Foot and Ankle Orthopaedic Surgery, PC | Orthopaedic Surgery | 523 E 72nd St, Room 509, New York, NY 10021-4099 | 2006-10-27 |
| 1407963200 | Walther H.o. Bohne | Orthopaedic Surgery | 535 E 70th St, New York, NY 10021-4872 | 2006-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.