DR. NICHOLAS C. ELLEFSON DO
NPI 1639699200
Family Medicine in Superior, WI

Q: What is Nicholas Ellefson's NPI number?

The NPI number for Nicholas Ellefson is 1639699200. It was assigned to this individual provider in the NPPES registry on June 23, 2017.

Q: What is Nicholas Ellefson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Ellefson was last updated on June 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 June 23, 2017PECOS EnrolledAccepts Medicare Assignment

3500 TOWER AVE, SUPERIOR, WI 54880(715) 817-7100(715) 817-7039 Get Directions Write a Review

NPPES record last updated: June 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2020, Oct 29, 2019, Jun 23, 2017 (3 updates tracked since 2017).

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About Dr. Nicholas C. Ellefson Do NPPES

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

DR. NICHOLAS C. ELLEFSON DO (NPI 1639699200) is an individual family medicine provider in Superior, Wisconsin, licensed in Wisconsin (71579-21) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Mary's Medical Center, and is a graduate of West Virginia School Of Osteopathic Medicine (2012).

NPPES Registry Identity

NPI1639699200

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICHOLAS C. ELLEFSONCredential: DO

Location Address3500 TOWER AVESuperior, WI 54880-4491

Mailing Address1702 University Dr SFargo, ND 58103-4940

Phone(715) 817-7100

Fax(715) 817-7039

Sole ProprietorNo

Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2012

Enumeration DateJune 23, 2017

Last NPPES UpdateJune 19, 20203 updates tracked since enumeration

NPPES CertifiedJune 19, 2020

✔ NPI 1639699200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WI · 71579-21✔ Licensed in MN · 66646✔ Licensed in WV · 3356

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3500 TOWER AVE, Superior, WI 54880

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicholas C. Ellefson Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092089938

PECOS Enrollment IDI20200713003364, I20201027002963

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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

181 services70 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

100 services39 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

55 services54 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

31 services31 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

15 services11 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

13 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Essentia Health St Mary's Medical Center

Acute Care Hospitals · Duluth, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240002

Location402 East Second StreetDuluth, MN 55805 · St. Louis County

Emergency services Birthing friendly

Essentia Health Duluth

Acute Care Hospitals · Duluth, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240019

Location502 East Second StreetDuluth, MN 55805 · St. Louis County

Birthing friendly

St Marys Hospital Superior

Critical Access Hospitals · Superior, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521329

Location3500 Tower AveSuperior, WI 54880 · Douglas County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54880 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

Referred Medical Equipment & Supplies CMS DME claims

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers13 claims13 services$79.02 avg. paid by Medicare

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

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.

MS. ERIN LEE FISKER PA-C

Physician Assistant