K ELLIS PA
NPI 1124885348
Nurse Practitioner - Psychiatric/Mental Health in Albuquerque, NM
About K Ellis Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
K ELLIS PA (NPI 1124885348) is a healthcare organization registered as a psychiatric/mental health in Albuquerque, New Mexico and active in the NPI registry since March 2024. The organization lists Keisha Ellis, Authorized Official/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
K Ellis Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to K Ellis PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 K Ellis PA's NPI number?
The NPI number for K Ellis PA is 1124885348. It was assigned to this organization in the NPPES registry on March 4, 2024.
Where is K Ellis PA located?
K Ellis PA is located at 1209 Mountain Road Pl NE # 4953, Albuquerque, NM 87110. The listed phone number is (904) 252-3606.
What is K Ellis PA's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is K Ellis PA enrolled in Medicare?
Yes. K Ellis PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through K Ellis PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to K Ellis PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for K Ellis PA was last updated on September 10, 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.
# K Ellis Pa · NPI 1124885348
Psychiatric/Mental Health organization in Albuquerque, New Mexico. Organization record, active in the CMS NPPES registry since March 4, 2024.
## Identity
- **NPI:** 1124885348 (Entity type: Organization)
- **Enumerated:** March 4, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Keisha Ellis, AUTHORIZED OFFICIAL/OWNER
## Practice location
- **Address:** 1209 MOUNTAIN ROAD PL NE # 4953, Albuquerque, NM 87110-7845
- **Phone:** (904) 252-3606 · **Fax:** (505) 546-4325
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 10, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1124885348) · Data from the CMS NPPES public registry.