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

Q: 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.

Q: What is Ryan Ellsworth's specialty?

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

Q: 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.

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: November 01, 2026.

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

On this page

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

Phone(404) 618-6077

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

Open in Google Maps ↗

Secondary Practice Locations 9

Location 14019 W 12600 S, Suite 120Riverton, UT 84096 · Phone (801) 253-6886 · Fax (801) 253-6888

Location 212523 S Creek Meadow Rd Ste 105Riverton, UT 84065-7299 · Phone (801) 253-6886 · Fax (801) 253-6888

Location 33355 N University Ave Ste 175Provo, UT 84604-6620 · Phone (801) 253-6886 · Fax (801) 253-6888

Location 4227 N Westwood BlvdPrice, UT 84501-5500 · Phone (801) 253-6886 · Fax (801) 253-6888

Location 512780 Race Track Rd Ste 417Tampa, FL 33626-1395 · Phone (813) 535-7707 · Fax (801) 253-6888

Location 63130 S Highland Dr Ste B4Salt Lake City, UT 84106-3095 · Phone (801) 253-6886 · 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 92019 E Riverside Dr Ste A101St George, UT 84790-8147 · 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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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

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.

Medicare Billing Reassignments

Medicare enrollment records show Ryan Ellsworth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Amble Medical

1,575 mi

Podiatrist

9980 S 300 W STE 300
Sandy, UT 84070

Reassigned Medicare billing, Utah enrollment
3 clinicians in this Medicare group

NPI 1134865595 (801) 253-6886

Ellsworth Foot And Ankle Clinic

1,580 mi

Foot & Ankle Surgery

12523 S CREEK MEADOW RD STE 105
Riverton, UT 84065

Reassigned Medicare billing, Utah enrollment
6 clinicians in this Medicare group

NPI 1942549795 (801) 253-6886

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

104 services29 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

103 services22 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

71 services52 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

70 services39 patients

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

65 services11 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

57 services32 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

55 services34 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

43 services27 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

36 services25 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

35 services20 patients

Injection of anesthetic and/or steroid drug into foot nerve 64455

This procedure involves injecting a combination of anesthetic and/or steroid medication into a nerve in your foot. It's designed to alleviate pain and inflammation. You may experience temporary numbness or relief in the treated area.

29 services20 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

24 services13 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

17 services17 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

16 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 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.

TAMANNA HOQUE DPM

Podiatrist (Foot & Ankle Surgery)

505 FAIRBURN RD SW STE 100
ATLANTA, GA 30331

Fulton County (404) 618-6077

ELLSWORTH FOOT AND ANKLE CLINIC

Clinic/Center (Podiatric)

505 FAIRBURN RD SW STE 100
ATLANTA, GA 30331

Fulton County (404) 618-6077

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.

Which organizations bill Medicare for Ryan Ellsworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Ellsworth reassigns Medicare benefits to 2 organizations: Amble Medical (Sandy, UT) and Ellsworth Foot And Ankle Clinic (Riverton, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Ellsworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ryan Ellsworth accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and BridgeSpan Health Company and 3 other insurers 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.