ELLEN DAVIS
NPI 1194384362
Physician Assistant - Surgical in Lakeland, FL

Q: What is Ellen Davis's NPI number?

The NPI number for Ellen Davis is 1194384362. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Q: What is Ellen Davis's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Ellen Davis was last updated on November 13, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 11, 2019PECOS EnrolledAccepts Medicare Assignment

80.11/100

CMS Quality Rating

130 PABLO ST, LAKELAND, FL 33803(863) 284-5906(863) 284-5149 Get Directions Write a Review

NPPES record last updated: November 13, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 13, 2019, Jun 11, 2019 (2 updates tracked since 2019).

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About Ellen Davis NPPES

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

ELLEN DAVIS (NPI 1194384362) is an individual surgical provider in Lakeland, Florida, licensed in Florida (PA9112245) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Lakeland Regional Medical Center, and is a graduate of Other.

NPPES Registry Identity

NPI1194384362

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameELLEN DAVIS

Location Address130 PABLO STLakeland, FL 33803-3818

Mailing Address1324 Lakeland Hills Blvd, Managed Care DeptLakeland, FL 33805-4543

Phone(863) 284-5906

Fax(863) 284-5149

Sole ProprietorYes

Medical School CMSOther

Enumeration DateJune 11, 2019

Last NPPES UpdateNovember 13, 20192 updates tracked since enumeration

✔ NPI 1194384362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9112245

Also ListedPhysician AssistantTaxonomy 363A00000X

130 PABLO ST, Lakeland, FL 33803

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ellen Davis 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.

PECOS PAC ID1254764418

PECOS Enrollment IDI20191203000782

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lakeland Regional Medical Center

Acute Care Hospitals · Lakeland, FL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100157

Location1324 Lakeland Hills BlvdLakeland, FL 33805 · Polk County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.11/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.29

Promoting Interoperability

Improvement Activities

Cost

64.85

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.

MS. CARRIE ANN PIERSON ARNP-C

Nurse Practitioner (Family)