SADIE ELLENSON MD
NPI 1275225831
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Q: What is Sadie Ellenson's NPI number?

The NPI number for Sadie Ellenson is 1275225831. It was assigned to this individual provider in the NPPES registry on May 23, 2023.

Q: What is Sadie Ellenson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Sadie Ellenson was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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 May 23, 2023PECOS Enrolled

1300 N 12TH ST STE 508, PHOENIX, AZ 85006(602) 839-3927 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Sadie Ellenson Md NPPES

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

SADIE ELLENSON MD (NPI 1275225831) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Grosse Pointe Woods.

NPPES Registry Identity

NPI1275225831

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSADIE ELLENSONCredential: MD

Location Address1300 N 12TH ST STE 508Phoenix, AZ 85006-2849

Mailing Address1300 N 12th St Ste 508Phoenix, AZ 85006-2849 · (602) 839-3927

Phone(602) 839-3927

Sole ProprietorNo

Enumeration DateMay 23, 2023

Last NPPES UpdateApril 22, 2025

NPPES CertifiedApril 22, 2025

✔ NPI 1275225831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1300 N 12TH ST STE 508, Phoenix, AZ 85006

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Secondary Practice Location 1

Location 119251 Mack Ave Ste 34Grosse Pointe Woods, MI 48236-2893 · Phone (313) 343-7843

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sadie Ellenson Md 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.

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.

TREVIN REYES MD

Student in an Organized Health Care Education/Training Program