MR. JUSTIN THOMAS ELLIS NP-BC, MSSM
NPI 1336959865
Nurse Practitioner - Family in Marietta, GA
About Mr. Justin Thomas Ellis Np-bc, Mssm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JUSTIN THOMAS ELLIS NP-BC, MSSM (NPI 1336959865) is an individual family provider in Marietta, Georgia, licensed in Georgia (2024093910) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2024).
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
Mr. Justin Thomas Ellis Np-bc, Mssm 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 Justin Ellis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Marietta, GA 30060
- Reassigned Medicare billing, Georgia enrollment
- 168 clinicians in this Medicare group
Atlanta, GA 30309
- Reassigned Medicare billing, Georgia enrollment
- 183 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 30066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARIETTA, GA 30066
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 Justin Ellis's NPI number?
The NPI number for Justin Ellis is 1336959865. It was assigned to this individual provider in the NPPES registry on January 8, 2025.
Where is Justin Ellis located?
Justin Ellis practices at 1809 Canton Rd, Marietta, GA 30066. The listed phone number is (678) 335-4865.
What is Justin Ellis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Justin Ellis enrolled in Medicare?
Yes. Justin 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 Justin Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Justin Ellis reassigns Medicare benefits to 2 organizations: Orthoatlanta, LLC (Marietta, GA) and Piedmont Orthopedics, LLC (Atlanta, GA). 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 Justin 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 Justin Ellis was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Mr. Justin Thomas Ellis, NP-BC, MSSM · NPI 1336959865
Family physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since January 8, 2025.
## Identity
- **NPI:** 1336959865 (Entity type: Individual)
- **Enumerated:** January 8, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 2024093910 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1809 CANTON RD, Marietta, GA 30066-6343
- **Phone:** (678) 335-4865
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Orthoatlanta, LLC (NPI 1720350747, Marietta, GA); Piedmont Orthopedics, LLC (NPI 1114317062, Atlanta, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** October 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1336959865) · Data from the CMS NPPES public registry.