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DR. JACK BRADLEY ELLIS D.O.
NPI 1003115254
Internal Medicine in Augusta, GA

Active since March 26, 2011PECOS EnrolledAccepts Medicare Assignment
77.82/100
CMS Quality Rating
1120 15TH ST, AUGUSTA, GA 30912(706) 721-8623 Get Directions Write a Review

NPPES record last updated: May 31, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jack Bradley Ellis D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK BRADLEY ELLIS D.O. (NPI 1003115254) is an individual internal medicine provider in Augusta, Georgia, licensed in Georgia (072627) and active in the NPI registry since March 2011. He is enrolled in Medicare PECOS, is affiliated with Au Medical Center, and maintains a secondary practice location in Joint Base Lewis Mcchord.

NPPES Registry Identity

NPI1003115254
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JACK BRADLEY ELLISCredential: D.O.
Location Address1120 15TH STAugusta, GA 30912
Mailing Address1499 Walton Way Ste 1400Augusta, GA 30901-2603 · (703) 724-6100
Phone(706) 721-8623
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 26, 2011
Last NPPES UpdateMay 31, 2018
✔ NPI 1003115254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 072627
Definition
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1120 15TH ST, Augusta, GA 30912
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Secondary Practice Location 1

Location 19040 Fitzsimmons DrJoint Base Lewis McChord, WA 98431-1000 · Phone (253) 968-0208

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Bradley Ellis D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729209903
PECOS Enrollment IDI20150317001692
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
246 services99 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
59 services57 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
37 services23 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
35 services35 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Au Medical Center

Acute Care Hospitals · Augusta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110034
Location1120 15th StreetAugusta, GA 30912 · Richmond County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.04
Promoting Interoperability92
Improvement Activities40
Cost60.7

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%68 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, heavy duty, wheeled, rigid or folding, any type E0149
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.36 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers12 claims12 services$14.44 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers12 claims12 services$61.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TOYA HESTER KELLEY MD
Family Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-3157
MR. ROBERT SCOTT SMITH FNP-C
Nurse Practitioner (Family)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8549
SAMI MOHAMMED ALSHEHRY
Student in an Organized Health Care Education/Training Program
1120 15TH ST, 1065
AUGUSTA, GA 30912
Richmond County (706) 721-2411
LUIS ALBERTO VELASQUEZ ZARATE M.D
Pathology (Anatomic Pathology & Clinical Pathology)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-2771
DR. BRYAN RICHARD BROACH M.D.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
JANELLE MCGILL M.D.
Pediatrics
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
DR. KAYLA ASHLEY SHAHBAZIAN DO
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
ROSA MARIA LOPEZ RINCON
Anesthesiology
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 446-5836

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Ellis's NPI number?

The NPI number for Jack Ellis is 1003115254. It was assigned to this individual provider in the NPPES registry on March 26, 2011.

Where is Jack Ellis located?

Jack Ellis practices at 1120 15th St, Augusta, GA 30912. The listed phone number is (706) 721-8623.

What is Jack Ellis's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Ellis enrolled in Medicare?

Yes. Jack Ellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Ellis accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Jack Ellis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jack Ellis affiliated with any hospitals?

According to CMS data, Jack Ellis is affiliated with Au Medical Center.

When was this NPI record last updated?

The NPPES record for Jack Ellis was last updated on May 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.