JOLENE ELLIS M.D.
NPI 1255395612
Pediatrics in Jackson, MI

Q: What is Jolene Ellis's NPI number?

The NPI number for Jolene Ellis is 1255395612. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Q: What is Jolene Ellis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jolene Ellis was last updated on March 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 April 13, 2006PECOS Enrolled

760 W FRANKLIN ST, JACKSON, MI 49201(517) 780-9260(517) 780-9263 Get Directions Write a Review

NPPES record last updated: March 3, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Jolene Ellis M.d. NPPES

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

JOLENE ELLIS M.D. (NPI 1255395612) is an individual pediatrics provider in Jackson, Michigan, licensed in Michigan (4301058029) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255395612

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJOLENE ELLISCredential: M.D.

Location Address760 W FRANKLIN STJackson, MI 49201-2048

Mailing Address760 W Franklin StJackson, MI 49201-2048 · (517) 780-9260 · Fax (517) 780-9263

Phone(517) 780-9260

Fax(517) 780-9263

Sole ProprietorNo

Enumeration DateApril 13, 2006

Last NPPES UpdateMarch 3, 2020

NPPES CertifiedMarch 3, 2020

✔ NPI 1255395612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 4301058029

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

760 W FRANKLIN ST, Jackson, MI 49201

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Other Identifiers 1

Medicaid4649460MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jolene Ellis M.d. 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 Jolene Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wa Foote Memorial Hospital Inc.

Same address

Pediatrics

760 W FRANKLIN ST
Jackson, MI 49201

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: W.A. Foote Memorial Hospital
62 clinicians in this Medicare group

NPI 1265806343 (517) 205-2700

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 49201 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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 15

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

CATHERINE UPHAM LLMSW

Social Worker (Clinical)