COLETTE MARK ELLIS MD
NPI 1629530225
General Practice in Fairborn, OH

Q: What is Colette Ellis's NPI number?

The NPI number for Colette Ellis is 1629530225. It was assigned to this individual provider in the NPPES registry on April 2, 2019.

Q: What is Colette Ellis's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Colette Ellis was last updated on July 27, 2022. 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.

Active since April 02, 2019PECOS Enrolled

81.6/100

CMS Quality Rating

1059 BAYWOOD DR, FAIRBORN, OH 45324(713) 339-0341 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 27, 2022, Jan 11, 2021, Nov 16, 2020 and 1 more (4 updates tracked since 2019).

On this page

About Colette Mark Ellis Md NPPES

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

COLETTE MARK ELLIS MD (NPI 1629530225) is an individual general practice provider in Fairborn, Ohio, licensed in Texas (S8030) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629530225

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameCOLETTE MARK ELLISCredential: MD

Location Address1059 BAYWOOD DRFairborn, OH 45324-2647

Mailing Address1059 Baywood DrFairborn, OH 45324-2647 · (713) 339-0341

Phone(713) 339-0341

Sole ProprietorNo

Enumeration DateApril 2, 2019

Last NPPES UpdateJuly 27, 20224 updates tracked since enumeration

NPPES CertifiedJuly 27, 2022

✔ NPI 1629530225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in TX · S8030

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedSurgeryTaxonomy 208600000X · License S8030 (TX)

1059 BAYWOOD DR, Fairborn, OH 45324

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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)

Colette Mark Ellis Md 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 Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.6/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

75.44

Promoting Interoperability

100

Improvement Activities

Cost

29.89

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Collagen dressing, sterile, size 16 sq. in. or less, each A6021

DME-Medical/Surgical Supplies · category DA023N

2 suppliers13 claims445 services$20.55 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196

DME-Medical/Surgical Supplies · category DA023N

2 suppliers17 claims548 services$7.19 avg. paid by Medicare

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6219

DME-Medical/Surgical Supplies · category DA023N

1 supplier22 claims748 services$0.93 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Colette Ellis's NPI number?

The NPI number for Colette Ellis is 1629530225. It was assigned to this individual provider in the NPPES registry on April 2, 2019.

Where is Colette Ellis located?

Colette Ellis practices at 1059 Baywood Dr, Fairborn, OH 45324. The listed phone number is (713) 339-0341.

What is Colette Ellis's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Colette Ellis enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Colette Ellis was last updated on July 27, 2022. 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.