CARRIE SUSANNE ELLIS AGACNP
NPI 1376372557
Nurse Practitioner - Acute Care in Newport Beach, CA

Q: What is Carrie Ellis's NPI number?

The NPI number for Carrie Ellis is 1376372557. It was assigned to this individual provider in the NPPES registry on July 29, 2024.

Q: What is Carrie Ellis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Carrie Ellis was last updated on January 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 July 29, 2024PECOS Enrolled

1 HOAG DR, NEWPORT BEACH, CA 92663(949) 764-5588 Get Directions Write a Review

NPPES record last updated: January 21, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 21, 2026, Jul 29, 2024 (2 updates tracked since 2024).

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About Carrie Susanne Ellis Agacnp NPPES

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

CARRIE SUSANNE ELLIS AGACNP (NPI 1376372557) is an individual acute care provider in Newport Beach, California, licensed in California (95030685) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1376372557

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameCARRIE SUSANNE ELLISCredential: AGACNP

Location Address1 HOAG DRNewport Beach, CA 92663-4162

Mailing Address1 Hoag DrNewport Beach, CA 92663-4162

Phone(949) 764-5588

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 29, 2024

Last NPPES UpdateJanuary 21, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 21, 2026

✔ NPI 1376372557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in CA · 95030685

1 HOAG DR, Newport Beach, CA 92663

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carrie Susanne Ellis Agacnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799265542

PECOS Enrollment IDI20260219001444

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92663 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 20

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

DR. JACK MIN KAN M.D.

Anesthesiology

1 HOAG DR, DEPT OF ANESTHESIOLOGY
NEWPORT BEACH, CA 92663

Orange County (858) 565-9666

DR. MICHAEL GRAY MD

Hospitalist