SAMANTHA ELLIS MS, RD
NPI 1285044750
Dietitian, Registered in Walden, NY
About Samantha Ellis Ms, Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA ELLIS MS, RD (NPI 1285044750) is an individual dietitian, registered in Walden, New York, licensed in New York (1033283) and active in the NPI registry since May 2014. She is a graduate of City University Of New York School Of Medicine (2011).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samantha Ellis Ms, Rd 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.
Medicare Billing Reassignments
2Medicare enrollment records show Samantha Ellis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Delmar, NY 12054
- Reassigned Medicare billing, New York enrollment
- 3 clinicians in this Medicare group
Mechancville, NY 12118
- Reassigned Medicare billing, New York enrollment
- 7 clinicians in this Medicare group
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 12586 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Samantha Ellis's NPI number?
The NPI number for Samantha Ellis is 1285044750. It was assigned to this individual provider in the NPPES registry on May 5, 2014.
Where is Samantha Ellis located?
Samantha Ellis practices at 44 Pleasant Ave, Walden, NY 12586. The listed phone number is (845) 597-8128.
What is Samantha Ellis's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Samantha Ellis enrolled in Medicare?
Yes. Samantha Ellis 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.
Which organizations bill Medicare for Samantha Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Ellis reassigns Medicare benefits to 2 organizations: Lgc Nutrition LLC (Delmar, NY) and Marc D Price Do PLLC (Mechancville, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Samantha Ellis was last updated on May 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Samantha Ellis, MS, RD · NPI 1285044750
Dietitian, Registered provider in Walden, New York. Individual provider, active in the CMS NPPES registry since May 5, 2014.
## Identity
- **NPI:** 1285044750 (Entity type: Individual)
- **Enumerated:** May 5, 2014
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** 1033283 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 44 PLEASANT AVE, Walden, NY 12586-1240
- **Phone:** (845) 597-8128
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Lgc Nutrition LLC (NPI 1750983995, Delmar, NY); Marc D Price Do PLLC (NPI 1902816473, Mechancville, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** City University Of New York School Of Medicine, class of 2011
## Record status
- **NPPES last updated:** May 5, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1285044750) · Data from the CMS NPPES public registry.