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ELLEN CANNON
NPI 1083169890
Physician Assistant in Philadelphia, PA

Active since August 22, 2016PECOS EnrolledAccepts Medicare Assignment
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(610) 209-6383 Get Directions Write a Review

NPPES record last updated: January 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2016, Aug 22, 2016 (2 updates tracked since 2016).

About Ellen Cannon NPPES

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

ELLEN CANNON (NPI 1083169890) is an individual physician assistant in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA058639) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Philadelphia, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1083169890
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameELLEN CANNON
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address1610 Christian St Apt 2Philadelphia, PA 19146-2066
Phone(610) 209-6383
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 22, 2016
Last NPPES UpdateJanuary 26, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2024
✔ NPI 1083169890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PA · MA058639
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License MA058639 (PA)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Secondary Practice Location 1

Location 1160 E Erie AvePhiladelphia, PA 19134-1011 · Phone (610) 209-6383

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

Ellen Cannon 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 ID5799145413
PECOS Enrollment IDI20240404003755
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 4

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 straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
30 services22 patients
Drainage of fluid from abdominal cavity using imaging guidance 49083
This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.
26 services16 patients
Imaging for evaluation of swallowing function 74230
This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.
17 services17 patients
Fine needle aspiration biopsy using ultrasound guidance, first growth 10005
Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
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 20

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

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Ellen Cannon's NPI number?

The NPI number for Ellen Cannon is 1083169890. It was assigned to this individual provider in the NPPES registry on August 22, 2016.

Where is Ellen Cannon located?

Ellen Cannon practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (610) 209-6383.

What is Ellen Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ellen Cannon enrolled in Medicare?

Yes. Ellen Cannon 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.

When was this NPI record last updated?

The NPPES record for Ellen Cannon was last updated on January 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.