RYAN SCOTT ELLSWORTH DPM
NPI 1104130574
Podiatrist - Foot Surgery in Atlanta, GA

Active since July 28, 2010PECOS Enrolled
75/100
CMS Quality Rating
505 FAIRBURN RD SW STE 100, ATLANTA, GA 30331(404) 618-6077(801) 253-6888 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2024, Jan 24, 2023, Apr 12, 2022 and 2 more (5 updates tracked since 2017).

About Ryan Scott Ellsworth Dpm NPPES

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

RYAN SCOTT ELLSWORTH DPM (NPI 1104130574) is an individual foot surgery provider in Atlanta, Georgia, licensed in Utah (8400193-0501) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, maintains 9 additional practice locations, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1104130574
Entity TypeIndividualMale
Primary Taxonomy213ES0131X
Provider Legal NameRYAN SCOTT ELLSWORTHCredential: DPM
Location Address505 FAIRBURN RD SW STE 100Atlanta, GA 30331-2012
Mailing Address9980 S 300 W Ste 300Sandy, UT 84070-3654 · (801) 273-0001 · Fax (801) 253-6888
Fax(801) 253-6888
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 28, 2010
Last NPPES UpdateJune 17, 20245 updates tracked since enumeration
NPPES CertifiedJune 17, 2024
NPI 1104130574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

Primary SpecialtyPodiatrist · Foot SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0131X
License Licensed in UT · 8400193-0501
Also ListedPodiatristTaxonomy 213E00000X · License 2109 (NV), E5797 (CA), PO4406 (FL), POD001473 (GA)
Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X · License 8400193-0501 (UT)
Also ListedPodiatrist · RadiologyTaxonomy 213ER0200X · License 8400193-0501 (UT)
Also ListedPodiatrist · Sports MedicineTaxonomy 213ES0000X · License 8400193-0501 (UT)
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X · License 8400193-0501 (UT)
505 FAIRBURN RD SW STE 100, Atlanta, GA 30331

Secondary Practice Locations 9

Location 14019 W 12600 S, Suite 120Riverton, UT 84096 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 23355 N University Ave Ste 175Provo, UT 84604-6620 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 3227 N Westwood BlvdPrice, UT 84501-5500 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 42019 E Riverside Dr Ste A101St George, UT 84790-8147 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 53130 S Highland Dr Ste B4Salt Lake City, UT 84106-3095 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 612780 Race Track Rd Ste 417Tampa, FL 33626-1395 · Phone (813) 535-7707 · Fax (801) 253-6888
Location 795 White Sage Ave Ste CDelta, UT 84624-5555 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 8770 S Highway 99Fillmore, UT 84631-5033 · Phone (801) 253-6886 · Fax (801) 253-6888
Location 912523 S Creek Meadow Rd Ste 105Riverton, UT 84065-7299 · Phone (801) 253-6886 · Fax (801) 253-6888

Other Identifiers 7

Medicaid1003111UT
Other8400193-0501UT · Ut Dpm License
Other7672880001UT · Dme
OtherE5797CA · Ca Dpm License
OtherPOD001473GA · Ga Dpm License
OtherPO4406FL · Fl Dpm License
Other2109NV · Nv Dpm License

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ryan Scott Ellsworth Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678719135
PECOS Enrollment IDI20130429000536, I20210203002196
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 21

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.

Restorigin, per square centimeter Q4191
Restorigin is a medical procedure that helps in the regeneration of skin tissue. It's typically used for wound healing and involves the application of skin cells to the affected area. The service is charged per square centimeter, relating to the size of the treatment area.
1,204 services14 patients
Xwrap, per square centimeter Q4204
Xwrap refers to a medical procedure where a special wrap is applied to a specific area of the body, measured per square centimeter. This wrap aids in healing, reduces swelling, and provides support. It's generally used for injuries or post-surgery care.
556 services12 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
231 services131 patients
Injection of anesthetic agent and/or steroid into other nerve or branch 64450
This procedure involves injecting an anesthetic agent or steroid into a specific nerve or its branch. The goal is to relieve pain by reducing inflammation and numbing the area. It is commonly used for chronic pain management. The process is safe and usually quick.
142 services59 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
141 services86 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
107 services47 patients

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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 2

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

Podiatrist (Foot & Ankle Surgery)
505 FAIRBURN RD SW STE 100
ATLANTA, GA 30331
Clinic/Center (Podiatric)
505 FAIRBURN RD SW STE 100
ATLANTA, GA 30331

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 Ryan Ellsworth's NPI number?

The NPI number for Ryan Ellsworth is 1104130574. It was assigned to this individual provider in the NPPES registry on July 28, 2010.

Where is Ryan Ellsworth located?

Ryan Ellsworth practices at 505 Fairburn Rd SW Ste 100, Atlanta, GA 30331. The listed phone number is (404) 618-6077.

What is Ryan Ellsworth's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot Surgery, with taxonomy code 213ES0131X.

Is Ryan Ellsworth enrolled in Medicare?

Yes. Ryan Ellsworth is registered in the Medicare PECOS enrollment system.

What insurance does Ryan Ellsworth accept?

Health plans from Alliant Health Plans, Inc., BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Ryan Ellsworth 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 Ryan Ellsworth was last updated on June 17, 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.