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DR. CHARLES LEE ELLIS DDS, MD
NPI 1013098698
Dentist - Oral and Maxillofacial Surgery in Green Bay, WI

Active since October 18, 2006Opted out of Medicare · through May 1, 2027
2353 S RIDGE ROAD, GREEN BAY, WI 54304(920) 499-0471(920) 499-8312 Get Directions Write a Review

NPPES record last updated: August 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Charles Lee Ellis Dds, Md NPPES

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

DR. CHARLES LEE ELLIS DDS, MD (NPI 1013098698) is an individual oral and maxillofacial surgery provider in Green Bay, Wisconsin, licensed in North Carolina (8919) and active in the NPI registry since October 2006. He has opted out of Medicare through May 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1013098698
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. CHARLES LEE ELLISCredential: DDS, MD
Location Address2353 S RIDGE ROADGreen Bay, WI 54304-5069
Mailing Address2353 S Ridge RoadGreen Bay, WI 54304-5069 · (920) 499-0471 · Fax (920) 499-8312
Phone(920) 499-0471
Fax(920) 499-8312
Sole ProprietorYes
Enumeration DateOctober 18, 2006
Last NPPES UpdateAugust 20, 2025
✔ NPI 1013098698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in NC · 8919✔ Licensed in VA · 0401411258✔ Licensed in IL · 019022235
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License 8919 (NC)
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 0101058265 (VA), 8919 (NC)
2353 S RIDGE ROAD, Green Bay, WI 54304
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Other Identifiers 1

Medicaid5914023NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Wisconsin, Inc., Humana.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Charles Lee Ellis Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 1, 2021 through May 1, 2027.

Opt-Out Effective DateMay 1, 2021
Opt-Out In Effect ThroughMay 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54304 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

BAY ORAL SURGERY & IMPLANT CENTER, LTD
Dentist (Oral and Maxillofacial Surgery)
2353 S RIDGE ROAD
GREEN BAY, WI 54304
Brown County (920) 499-0471

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 Charles Ellis's NPI number?

The NPI number for Charles Ellis is 1013098698. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Charles Ellis located?

Charles Ellis practices at 2353 S Ridge Road, Green Bay, WI 54304. The listed phone number is (920) 499-0471.

What is Charles Ellis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Charles Ellis enrolled in Medicare?

No. Charles Ellis has opted out of Medicare through May 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Charles Ellis accept?

Health plans from Delta Dental of Wisconsin, Inc. and Humana list Charles 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.

When was this NPI record last updated?

The NPPES record for Charles Ellis was last updated on August 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.