DR. DONOVAN ELLIS PHD
NPI 1124794243
Psychologist - Clinical in Atlanta, GA
About Dr. Donovan Ellis Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DONOVAN ELLIS PHD (NPI 1124794243) is an individual clinical provider in Atlanta, Georgia, licensed in Georgia (PSY004807) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Donovan Ellis Phd 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.
Medicare Billing Reassignment
Medicare enrollment records show Donovan Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30322
- Reassigned Medicare billing, Georgia enrollment
- 4,840 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30329 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ATLANTA, GA 30329
ATLANTA, GA 30329
ATLANTA, GA 30329
ATLANTA, GA 30329
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 Donovan Ellis's NPI number?
The NPI number for Donovan Ellis is 1124794243. It was assigned to this individual provider in the NPPES registry on August 18, 2021.
Where is Donovan Ellis located?
Donovan Ellis practices at 12 Executive Park Dr NE, Atlanta, GA 30329. The listed phone number is (404) 941-5381.
What is Donovan Ellis's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Donovan Ellis enrolled in Medicare?
Yes. Donovan 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.
Which organization bills Medicare for Donovan Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Donovan Ellis reassigns Medicare benefits to The Emory Clinic Inc (Atlanta, GA). The 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 Donovan Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Donovan Ellis accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Donovan 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 Donovan Ellis was last updated on August 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.
# Dr. Donovan Ellis, PHD · NPI 1124794243
Clinical provider in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since August 18, 2021.
## Identity
- **NPI:** 1124794243 (Entity type: Individual)
- **Enumerated:** August 18, 2021
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY004807 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 12 EXECUTIVE PARK DR NE, Atlanta, GA 30329-2206
- **Phone:** (404) 941-5381
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** The Emory Clinic Inc (NPI 1396798229, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** August 26, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1124794243) · Data from the CMS NPPES public registry.