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

Q: 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.

Q: What is Keith Ellis's specialty?

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

Q: 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 3 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 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: August 02, 2026.

On this page

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

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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 Providence Health Plan.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)

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.

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