DR. HERMAN MARTIN ELLIS MD
NPI 1386768612
Preventive Medicine - Addiction Medicine in Newark, DE

NPI Status: Active since March 19, 2007

Contact Information

100 BIDDLE AVE STE 101
NEWARK, DE
ZIP 19702
Phone: (410) 505-8605
Fax: (240) 770-0436

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Preventive Medicine
Addiction Medicine
Accepts Insurance
PECOS Enrolled

About HERMAN ELLIS

This page provides the complete NPI Profile along with additional information for Herman Ellis, a provider established in Newark, Delaware with a medical specialization in Preventive Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1386768612 assigned on March 2007. The practitioner's primary taxonomy code is 2083A0300X with license number C10007434 (DE). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1386768612
Provider Name: DR. HERMAN MARTIN ELLIS MD
Gender: Male
Entity Type: Individual
Location Address: 100 BIDDLE AVE STE 101 NEWARK, DE 19702
Location Phone: (410) 505-8605
Location Fax: (240) 770-0436
Mailing Address: 9123 OLD ANNAPOLIS RD STE 203&204 COLUMBIA, MD 21045
Mailing Phone: (410) 505-8605
Mailing Fax: (240) 770-0436
Is Sole Proprietor?: No
Enumeration Date: 03-19-2007
Last Update Date: 06-06-2023
Code Navigator

Location Map

Secondary Locations

9123 Old Annapolis Rd Ste 203&204
Columbia, MD 21045
(410) 505-8605

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Preventive Medicine Addiction Medicine
Taxonomy Code: 2083A0300X
Type: Allopathic & Osteopathic Physicians
License No.: C10007434
License State: DE
Taxonomy Description: A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	2083P0901X	Allopathic & Osteopathic Physicians	Preventive Medicine Public Health & General Preventive Medicine	C1-0007434 (DE)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

AmeriHealth Caritas Next

AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
AmeriHealth Caritas Next Silver Signature + No Referrals - HMO

Highmark Blue Cross Blue Shield Delaware

my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
my Blue Access Select PPO Bronze 3800 - PPO
my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
my Blue Access Select PPO Bronze 9200 - PPO
my Blue Access Select PPO Gold 0 - PPO
my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Gold 1700 HSA - PPO
my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Standard Bronze 7500 - PPO
my Blue Access Select PPO Standard Gold 2000 - PPO
my Blue Access Select PPO Standard Gold 2000 + Adult Dental and Vision - PPO
my Blue Access Select PPO Standard Platinum 0 - PPO
my Blue Access Select PPO Standard Silver 6000 - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Herman Ellis is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 10-19 minutes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 19702 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $131.15
Minimum New Patient Price $57.12
Maximum New Patient Price $173.08

Average New Patient Copayment $32.78
Minimum New Patient Copayment $14.28
Maximum New Patient Copayment $43.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $100.68
Minimum Established Patient Price $18.36
Maximum Established Patient Price $141.05

Average Established Patient Copayment $25.17
Minimum Established Patient Copayment $4.59
Maximum Established Patient Copayment $35.26

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1386768612, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 7 → 14 → 5 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 6 + 6 + 1 + 4 + 6 + 1 + 6 + 6 + 2 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2

This NPI is valid

The calculated check digit is 2, which matches the last digit of 1386768612.