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DEANDREA ELLIS
NPI 1477057354
Pediatrics in Atlanta, GA

Active since March 23, 2018PECOS Enrolled
3655 ROSWELL RD NE STE 130A, ATLANTA, GA 30342(470) 472-1965(470) 472-7964 Get Directions Write a Review

NPPES record last updated: January 7, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 7, 2026, Nov 8, 2021, Mar 23, 2018 (3 updates tracked since 2018).

About Deandrea Ellis NPPES

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

DEANDREA ELLIS (NPI 1477057354) is an individual pediatrics provider in Atlanta, Georgia, licensed in Georgia (97622) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477057354
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDEANDREA ELLIS
Location Address3655 ROSWELL RD NE STE 130AAtlanta, GA 30342-4428
Mailing Address3655 Roswell Rd Ne Ste 130aAtlanta, GA 30342-4428 · (470) 472-1965 · Fax (420) 472-1964
Phone(470) 472-1965
Fax(470) 472-7964
Sole ProprietorNo
Enumeration DateMarch 23, 2018
Last NPPES UpdateJanuary 7, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2026
✔ NPI 1477057354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 97622
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3655 ROSWELL RD NE STE 130A, Atlanta, GA 30342
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Deandrea Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Summit Medical Group PA
723 mi
Multi-Specialty
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
Berkeley Heights, NJ 07922
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,184 clinicians in this Medicare group
NPI 1942254347 (908) 273-4300

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 30342 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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 Deandrea Ellis's NPI number?

The NPI number for Deandrea Ellis is 1477057354. It was assigned to this individual provider in the NPPES registry on March 23, 2018.

Where is Deandrea Ellis located?

Deandrea Ellis practices at 3655 Roswell Rd NE Ste 130A, Atlanta, GA 30342. The listed phone number is (470) 472-1965.

What is Deandrea Ellis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Deandrea Ellis enrolled in Medicare?

Yes. Deandrea Ellis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Deandrea Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deandrea Ellis reassigns Medicare benefits to Summit Medical Group PA (Berkeley Heights, NJ). The 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 Deandrea Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deandrea Ellis accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Deandrea Ellis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deandrea Ellis was last updated on January 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.