JOHN M ELLIS (NPI# 1962464818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962464818 |
| Entity Type | Individual |
| Full Name | JOHN M ELLIS |
| Credential | MD |
| Practice Address |
185 Genesee St Suite 600 Utica NY 13501-2199 |
| Practice Telephone | 3157938806 |
| Practice Fax Number | 3157938046 |
| Mailing Telephone | 3157938806 |
| Mailing Fax Number | 3157938046 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
209356 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | FIDELIS | 040426013962 | 01 |
| NY | CDPHP | 10037625 | 01 |
| NY | RAIL ROAD MEDICARE | 300099765 | 01 |
| NY | MVP | 960976 | 01 |
| NY | 01874611 | 05 | |
| NY | WC | 209356-1 | 01 |
| NY | GHI | 4199650 | 01 |
| NY | BCBS | P010209356 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013613 | John Ellis Iv | Pharmacist | 135 Rudders Xing, Newnan, GA 30263-7032 | 2020-11-02 |
| 1407495617 | John Leonard Ellis | Psychologist | 4439 Walnut Ridge Rd, Lenoir, NC 28645-3989 | 2020-01-06 |
| 1750637393 | John Darris Ellis | Marriage & Family Therapist | Yellowstone Behavioral Health 2538 Big Horn Ave, Cody Office, Cody, WY 82414-9299 | 2012-08-01 |
| 1538353552 | John Conard Ellis | Pediatrics | 7414 Hazelwood Ave, Indianapolis, IN 46260-3471 | 2007-09-03 |
| 1962619031 | John Paul Ellis | Psychologist | 1108 Grand Avenue, #2, St Paul, MN 55105-2614 | 2007-05-17 |
| 1437276300 | John Bockhoff Ellis | Dentist | 2901 S Florida Ave, Lakeland, FL 33803-4032 | 2007-03-23 |
| 1376670935 | John A Ellis | Family Medicine | 337 Sterling Road, South Lancaster, MA 01561 | 2007-02-28 |
| 1083798557 | John Franklin Ellis | Chiropractor | 2368 Us Highway 23 N, Ste 102, Weber City, VA 24290-7384 | 2006-10-24 |
| 1194831115 | John Lynn Ellis | Chiropractor | 3391 County Road 2240, Salem, MO 65560-8546 | 2006-08-22 |
| 1922011378 | John A Ellis | Dentist | 444 Wilton Rd, Farmington, ME 04938-6135 | 2006-08-15 |
| Street Address |
185 GENESEE ST SUITE 600 |
| City | UTICA |
| State | NY |
| Zip Code | 13501-2199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720040678 | John Paul Badami | Radiology | 185 Genesee St, Suite 600, Utica, NY 13501-2199 | 2006-04-05 |
| 1114399847 | Denise Slack | Case Manager/Care Coordinator | 185 Genesee St, Utica, NY 13501-2102 | 2015-10-21 |
| 1962825661 | Kimberly Brucker | Case Manager/Care Coordinator | 185 Genesee St, Utica, NY 13501-2102 | 2014-01-31 |
| 1821350034 | Michelle M Jones | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-13 |
| 1205198793 | Robin Ann Calandra | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| 1831451228 | Marc Dimaggio | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| 1225390636 | Susan Jean Strail | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| 1932461340 | Sally Hollandt Taylor | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| 1346502747 | Edina Mistric | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| 1659633055 | Patricia Jeanne Meyer | Case Manager/Care Coordinator | 185 Genesee St, 4th Floor, Utica, NY 13501-2102 | 2012-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700349248 | Maria Kuehl | Student in an Organized Health Care Education/Training Program | 120 Hobart Street, Residency Program, Utica, NY 13501 | 2019-04-11 |
| 1497237622 | Bobs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 430 Bleecker St, Utica, NY 13501 | 2018-09-04 |
| 1528565421 | Michele Della Gala | Social Worker | 1427 Genesee Street, Utica, NY 13501 | 2018-04-09 |
| 1295274884 | Sheila Denita Boyd | Licensed Practical Nurse | 505 Mary Street, Utica, NY 13501 | 2017-02-16 |
| 1770034993 | Curry Mcmahon | Massage Therapist | 2707 Genesee St, Utica, NY 13501 | 2016-10-24 |
| 1689123614 | Angelica Pascone Martin | Physician Assistant | 2215 Genesee St., Utica, NY 13501 | 2016-10-03 |
| 1942673942 | Krista Lee Klopotek | Registered Nurse | 1151 Albany Street, Albany Elementary School, Utica, NY 13501 | 2015-11-12 |
| 1841618089 | Katherine Macaulay Lucey | Social Worker | 293 Genesee Street, The Neighborhood Center, Inc. Human Resources, Utica, NY 13501 | 2014-04-04 |
| 1578809067 | Laurie A Baker | Social Worker | 2307 Genesee St, Utica, NY 13501 | 2013-01-02 |
| 1104170505 | Amanda Knoeller | Social Worker | 683 Mary Street, Utica, NY 13501 | 2012-11-07 |
| Find all providers in zip 13501 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720040678 | John Paul Badami | Radiology | 185 Genesee St, Suite 600, Utica, NY 13501-2199 | 2006-04-05 |
| 1588625297 | John M Mckennan | Radiology | 107 Business Park Dr, Utica, NY 13502-6399 | 2006-03-31 |
| 1154304434 | Randy L Niblett | Radiology | 2209 Genesee Street, Utica, NY 13501-5930 | 2005-11-21 |
| 1437493731 | South Utica Digital Imaging. LLC | Radiology | 2709 Genesee St, Utica, NY 13501-6222 | 2012-11-27 |
| 1548571144 | Aaron Himchak | Radiology | 185 Genesee St, Suite 600, Utica, NY 13501-2102 | 2010-06-29 |
| 1346459617 | Srinivas R Paidy | Radiology | 2209 Genesee Street, Utica, NY 13501-5930 | 2007-05-22 |
| 1447382106 | New Hartford Scanner Associates | Radiology | 1656 Champlin Ave, Suite 229, Utica, NY 13502-4830 | 2007-03-09 |
| 1386770527 | Brian T Burke | Radiology | 2209 Genesee Street, Utica, NY 13501-4308 | 2007-02-24 |
| 1033280458 | Michael R. Aiello | Radiology | 2209 Genesee Street, Utica, NY 13501 | 2006-11-10 |
| 1992888077 | Richard Blair | Radiology | 107 Business Park Dr, Utica, NY 13502-6303 | 2006-10-23 |
| Find all providers in UTICA | ||||
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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.