DR. ELLIOT CARR PENNINGTON MD
NPI 1235365081
Surgery - Pediatric Surgery in Grand Rapids, MI

Active since June 08, 2009PECOS EnrolledAccepts Medicare Assignment
330 BARCLAY AVE NE STE 202, GRAND RAPIDS, MI 49503(616) 443-8007(616) 458-0061 Get Directions Write a Review

NPPES record last updated: March 14, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 14, 2023, Mar 8, 2023, Aug 13, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Elliot Carr Pennington Md NPPES

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

DR. ELLIOT CARR PENNINGTON MD (NPI 1235365081) is an individual pediatric surgery provider in Grand Rapids, Michigan, licensed in Michigan (1235365081) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Missouri, Columbia School Of Medicine (2009).

NPPES Registry Identity

NPI1235365081
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameDR. ELLIOT CARR PENNINGTONCredential: MD
Location Address330 BARCLAY AVE NE STE 202Grand Rapids, MI 49503-2525
Mailing Address330 Barclay Ave Ne Ste 201Grand Rapids, MI 49503-2525 · (616) 458-1722
Fax(616) 458-0061
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2009
Enumeration DateJune 8, 2009
Last NPPES UpdateMarch 14, 20234 updates tracked since enumeration
NPPES CertifiedMarch 14, 2023
NPI 1235365081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Licenses Licensed in MI · 1235365081 Licensed in TX · U2104
Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

330 BARCLAY AVE NE STE 202, Grand Rapids, MI 49503

Secondary Practice Locations 2

Location 1333 N Santa RosaSan Antonio, TX 78207-3108 · Phone (713) 798-1750 ext. 2 · Fax (713) 798-4693
Location 2330 Barclay Ave NE Ste 202Grand Rapids, MI 49503-2525 · Phone (616) 458-1722 · Fax (616) 458-0061

Accepted Insurance

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

Dr. Elliot Carr Pennington Md 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 ID9931332962
PECOS Enrollment IDI20181105001638
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Pediatrics, Critical Care)
330 BARCLAY AVE NE STE 202
GRAND RAPIDS, MI 49503
Surgery (Pediatric Surgery)
330 BARCLAY AVE NE STE 202
GRAND RAPIDS, MI 49503

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 Elliot Pennington's NPI number?

The NPI number for Elliot Pennington is 1235365081. It was assigned to this individual provider in the NPPES registry on June 8, 2009.

Where is Elliot Pennington located?

Elliot Pennington practices at 330 Barclay Ave NE Ste 202, Grand Rapids, MI 49503. The listed phone number is (616) 443-8007.

What is Elliot Pennington's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Elliot Pennington enrolled in Medicare?

Yes. Elliot Pennington is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Elliot Pennington accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Molina Healthcare, Priority Health and UnitedHealthcare list Elliot Pennington 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 Elliot Pennington was last updated on March 14, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.