LEONARD ELLISON JR MD PC
NPI 1609821537
Internal Medicine in Southfield, MI
About Leonard Ellison Jr Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEONARD ELLISON JR MD PC (NPI 1609821537) is a healthcare organization registered as an internal medicine in Southfield, Michigan and active in the NPI registry since May 2006. The organization lists Leonard Ellison, Owner/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Leonard Ellison Jr Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Leonard Ellison Jr MD PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Leonard Ellison Jr MD PC's NPI number?
The NPI number for Leonard Ellison Jr MD PC is 1609821537. It was assigned to this organization in the NPPES registry on May 22, 2006.
Where is Leonard Ellison Jr MD PC located?
Leonard Ellison Jr MD PC is located at 17330 Northland Park Ct, Southfield, MI 48075. The listed phone number is (248) 552-9500.
What is Leonard Ellison Jr MD PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Leonard Ellison Jr MD PC enrolled in Medicare?
Yes. Leonard Ellison Jr MD PC is registered in the Medicare PECOS enrollment system.
When is Leonard Ellison Jr MD PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Leonard Ellison Jr MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Leonard Ellison Jr MD PC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (3) and Internal Medicine (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Leonard Ellison Jr MD PC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Leonard Ellison Jr MD PC 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 Leonard Ellison Jr MD PC was last updated on December 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Leonard Ellison Jr Md Pc · NPI 1609821537
Internal Medicine organization in Southfield, Michigan. Organization record, active in the CMS NPPES registry since May 22, 2006.
## Identity
- **NPI:** 1609821537 (Entity type: Organization)
- **Enumerated:** May 22, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Leonard Ellison, OWNER/PHYSICIAN
## Practice location
- **Address:** 17330 NORTHLAND PARK CT, Southfield, MI 48075-4318
- **Phone:** (248) 552-9500 · **Fax:** (248) 552-8144
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Internal Medicine (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 27, 2013
- **Other identifiers:** Other 110F312710 (MI); Medicaid 4709307 (MI); Medicare UPIN A76736 (MI); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1609821537) · Data from the CMS NPPES public registry.