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KEITH LAWRENCE ELLIS
NPI 1144654666
Nurse Practitioner - Pediatrics in Bridgeport, CT

Active since September 03, 2013PECOS Enrolled
46 ALBION ST, BRIDGEPORT, CT 06605(203) 330-6000(203) 330-6008 Get Directions Write a Review

NPPES record last updated: September 12, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Keith Lawrence Ellis NPPES

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

KEITH LAWRENCE ELLIS (NPI 1144654666) is an individual pediatrics provider in Bridgeport, Connecticut, licensed in Connecticut (5501) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hartford.

NPPES Registry Identity

NPI1144654666
Entity TypeIndividualMale
Primary Taxonomy363LP0200X
Provider Legal NameKEITH LAWRENCE ELLIS
Location Address46 ALBION STBridgeport, CT 06605-2602
Mailing Address46 Albion StBridgeport, CT 06605-2602 · (203) 330-6000 · Fax (203) 330-6008
Phone(203) 330-6000
Fax(203) 330-6008
Sole ProprietorNo
Enumeration DateSeptember 3, 2013
Last NPPES UpdateSeptember 12, 2022
NPPES CertifiedSeptember 12, 2022
✔ NPI 1144654666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CT · 5501
46 ALBION ST, Bridgeport, CT 06605
Open in Google Maps ↗

Secondary Practice Location 1

Location 1282 Washington StHartford, CT 06106-3322 · Phone (860) 837-7250 · Fax (860) 837-6970

Other Identifiers 1

Medicaid004236136CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith Lawrence Ellis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Keith Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Connecticut Children's Specialty Group, Inc.
49 mi
Pediatrics
282 WASHINGTON ST
Hartford, CT 06106
  • Reassigned Medicare billing, Connecticut enrollment
  • 601 clinicians in this Medicare group
NPI 1669448882 (860) 545-9000

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 06605 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
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.

KENDRA N DASCANO LPC-A
Counselor
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DR. SAMANTHA MRAZ DNP
Nurse Practitioner (Psychiatric/Mental Health)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 332-3584
MARLENE CUEVAS
Nurse Practitioner (Psychiatric/Mental Health)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (845) 664-3367
CLAUDE LOUIS
Counselor (Professional)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 644-4422
MRS. CLAUDIA PREISICK LPC
Counselor (Professional)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DANA BRUNELL EISENBERG
Nurse Practitioner (Pediatrics)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DR. STEVE SHAH MD
Family Medicine
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
BRITTNEY MARIE CIFARELLI DNP
Nurse Practitioner (Pediatrics)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000

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 Keith Ellis's NPI number?

The NPI number for Keith Ellis is 1144654666. It was assigned to this individual provider in the NPPES registry on September 3, 2013.

Where is Keith Ellis located?

Keith Ellis practices at 46 Albion St, Bridgeport, CT 06605. The listed phone number is (203) 330-6000.

What is Keith Ellis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Keith Ellis enrolled in Medicare?

Yes. Keith Ellis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keith Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Ellis reassigns Medicare benefits to Connecticut Children's Specialty Group, Inc. (Hartford, CT). 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 Keith Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keith Ellis accept?

Health plans from Anthem Blue Cross and Blue Shield list Keith 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 Keith Ellis was last updated on September 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.