DR. ELLIS SENANU KOJO SAMPRAM M.D, PHD
NPI 1174769186
General Practice in Toledo, OH

NPI Status: Active since December 22, 2008

Contact Information

3000 ARLINGTON AVE
MS 1095
TOLEDO, OH
ZIP 43614
Phone: (419) 383-6462

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  • Individual
  • Male
  • Years of Experience 14
  • General Practice
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ELLIS SAMPRAM

This page provides the complete NPI Profile along with additional information for Ellis Sampram, a primary care provider established in Toledo, Ohio with a medical specialization in General Practice and more than 14 years of experience. The healthcare provider is registered in the NPI registry with number 1174769186 assigned on December 2008. The practitioner's primary taxonomy code is 208D00000X with license number 35-093533 (OH). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1174769186
Provider Name
DR. ELLIS SENANU KOJO SAMPRAM M.D, PHD
Gender
Male
Entity Type
Individual
Location Address
3000 ARLINGTON AVE MS 1095 TOLEDO, OH 43614
Location Phone
(419) 383-6462
Mailing Address
3000 ARLINGTON AVE MS 1095 TOLEDO, OH 43614
Medical School Name
OTHER
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
12-22-2008
Last Update Date
07-23-2025
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A primary care provider (PCP) like Ellis Sampram sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
License No.
35-093533
License State
OH
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208600000XAllopathic & Osteopathic Physicians

Surgery

35-093533 (OH)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Ellis Sampram is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Ellis Sampram is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 244464576

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20130927000679

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Medical/Surgical Supplies (DA023N)

    Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)

    1 DME suppliers used 98 Medicare Claims 1715 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)

    1 DME suppliers used 52 Medicare Claims 1249 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6209)

    1 DME suppliers used 17 Medicare Claims 202 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)

    1 DME suppliers used 16 Medicare Claims 185 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6219)

    1 DME suppliers used 275 Medicare Claims 7577 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6222)

    1 DME suppliers used 90 Medicare Claims 3207 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6234)

    1 DME suppliers used 23 Medicare Claims 264 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6245)

    1 DME suppliers used 15 Medicare Claims 281 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Hydrogel dressing, wound filler, gel, per fluid ounce (HCPCS:A6248)

    1 DME suppliers used 66 Medicare Claims 216 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)

    1 DME suppliers used 64 Medicare Claims 1877 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

    1 DME suppliers used 27 Medicare Claims 1137 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

    1 DME suppliers used 46 Medicare Claims 1266 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard (HCPCS:A6450)

    1 DME suppliers used 11 Medicare Claims 180 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6454)

    1 DME suppliers used 12 Medicare Claims 630 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6456)

    1 DME suppliers used 27 Medicare Claims 1720 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of chemical to stop tissue regrowth in wound

This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.

This service was performed 62 times for 23 patients

Application of chemical to stop tissue regrowth in wound

This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.

This service was performed 175 times for 22 patients

Follow-up nursing facility visit per day, typically 10 minutes

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

This service was performed 61 times for 53 patients

Follow-up nursing facility visit per day, typically 10 minutes

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

This service was performed 188 times for 112 patients

Follow-up nursing facility visit per day, typically 15 minutes

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.

This service was performed 190 times for 96 patients

Follow-up nursing facility visit per day, typically 15 minutes

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.

This service was performed 666 times for 156 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 220 times for 94 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 503 times for 140 patients

Initial nursing facility visit per day, typically 25 minutes

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

This service was performed 66 times for 66 patients

Initial nursing facility visit per day, typically 25 minutes

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

This service was performed 59 times for 58 patients

Initial nursing facility visit per day, typically 35 minutes

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

This service was performed 80 times for 80 patients

Initial nursing facility visit per day, typically 35 minutes

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

This service was performed 55 times for 55 patients

Removal of bone, 20.0 sq cm or less

The procedure involves the surgical removal of a section of bone, up to 20.0 square cm in size. This may be necessary due to various reasons such as injury, infection, or to treat a disease. The process aims to alleviate pain, enhance mobility, or prevent the spread of disease.

This service was performed 43 times for 16 patients

Removal of bone, 20.0 sq cm or less

The procedure involves the surgical removal of a section of bone, up to 20.0 square cm in size. This may be necessary due to various reasons such as injury, infection, or to treat a disease. The process aims to alleviate pain, enhance mobility, or prevent the spread of disease.

This service was performed 167 times for 23 patients

Removal of muscle and/or tissue, 20.0 sq cm or less

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

This service was performed 245 times for 71 patients

Removal of muscle and/or tissue, 20.0 sq cm or less

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

This service was performed 670 times for 110 patients

Removal of skin and tissue, 20.0 sq cm or less

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.

This service was performed 168 times for 62 patients

Removal of skin and tissue, 20.0 sq cm or less

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.

This service was performed 516 times for 87 patients

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1174769186, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 7 → 14 → 5 9 → 18 → 9 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 4 + 4 + 1 + 4 + 6 + 1 + 8 + 1 + 1 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1174769186.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Surgery
3000 ARLINGTON AVE
TOLEDO, OH 43614
Nurse Anesthetist, Certified Registered
3000 ARLINGTON AVE, ANESTHESIA
TOLEDO, OH 43614
Internal Medicine (Cardiovascular Disease)
3000 ARLINGTON AVE, MEDICINE
TOLEDO, OH 43614
Nurse Anesthetist, Certified Registered
3000 ARLINGTON AVE, ANTESTHSIA
TOLEDO, OH 43614
Anesthesiologist Assistant
3000 ARLINGTON AVE, ANESTHESIA
TOLEDO, OH 43614
Dentist (Prosthodontics)
3000 ARLINGTON AVE, MAIL STOP 1092
TOLEDO, OH 43614
Surgery
3000 ARLINGTON AVE
TOLEDO, OH 43614
Pharmacist (Pharmacotherapy)
3000 ARLINGTON AVE, MAIL STOP 1060
TOLEDO, OH 43614
Social Worker (Clinical)
3000 ARLINGTON AVE, MAIL STOP 1161
TOLEDO, OH 43614
Pharmacist
3000 ARLINGTON AVE, MS 1060
TOLEDO, OH 43614
Pharmacist (Pharmacotherapy)
3000 ARLINGTON AVE, DEPARTMENT OF PHARMACY
TOLEDO, OH 43614
Pharmacist
3000 ARLINGTON AVE, UT MEDICAL CENTER
TOLEDO, OH 43614
Pharmacist (Pharmacotherapy)
3000 ARLINGTON AVE, UNIVERSITY OF TOLEDO MEDICAL CENTER
TOLEDO, OH 43614
Physical Therapy Assistant
3000 ARLINGTON AVE
TOLEDO, OH 43614
Speech-Language Pathologist
3000 ARLINGTON AVE
TOLEDO, OH 43614
Physical Therapist
3000 ARLINGTON AVE
TOLEDO, OH 43614
Clinical Nurse Specialist
3000 ARLINGTON AVE
TOLEDO, OH 43614
Anesthesiology
3000 ARLINGTON AVE
TOLEDO, OH 43614
Nurse Anesthetist, Certified Registered
3000 ARLINGTON AVE, FLOOR 2, ROOM 2195
TOLEDO, OH 43614
Pathology (Anatomic Pathology & Clinical Pathology)
3000 ARLINGTON AVE
TOLEDO, OH 43614

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174769186, enumerated as an "individual" on December 22, 2008.

The provider is located at 3000 ARLINGTON AVE MS 1095 TOLEDO, OH 43614 and the phone number is (419) 383-6462.

General Practice with taxonomy code 208D00000X.

The provider might be accepting Accepts: CareSource. Please consult your insurance carrier or call the provider to verify.