MR. ZACKRY CALVIN ELLIS PA-C
NPI 1366536278
Physician Assistant - Surgical in Newport Beach, CA
About Mr. Zackry Calvin Ellis Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. ZACKRY CALVIN ELLIS PA-C (NPI 1366536278) is an individual surgical provider in Newport Beach, California, licensed in California (PA18593) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses
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
Mr. Zackry Calvin Ellis Pa-c 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.
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 Zackry Ellis's NPI number?
The NPI number for Zackry Ellis is 1366536278. It was assigned to this individual provider in the NPPES registry on October 3, 2006.
Where is Zackry Ellis located?
Zackry Ellis practices at 307 Placentia Ave Ste 111, Newport Beach, CA 92663. The listed phone number is (949) 722-1112.
What is Zackry Ellis's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Zackry Ellis enrolled in Medicare?
Yes. Zackry 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.
When was this NPI record last updated?
The NPPES record for Zackry Ellis was last updated on October 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mr. Zackry Calvin Ellis, PA-C · NPI 1366536278
Surgical physician in Newport Beach, California. Individual provider, active in the CMS NPPES registry since October 3, 2006.
## Identity
- **NPI:** 1366536278 (Entity type: Individual)
- **Enumerated:** October 3, 2006
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** PA18593 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 307 PLACENTIA AVE STE 111, Newport Beach, CA 92663-3307
- **Phone:** (949) 722-1112
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** October 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1366536278) · Data from the CMS NPPES public registry.