DR. ELLIS ENABOSI M.D.
NPI 1669866158
Internal Medicine in Staten Island, NY

Active since March 24, 2015PECOS EnrolledAccepts Medicare Assignment
455 JERSEY ST, STATEN ISLAND, NY 10301(187) 524-5611 Get Directions Write a Review

NPPES record last updated: January 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 8, 2021, Dec 11, 2019, Feb 26, 2018 and 1 more (4 updates tracked since 2016).

About Dr. Ellis Enabosi M.d. NPPES

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

DR. ELLIS ENABOSI M.D. (NPI 1669866158) is an individual internal medicine provider in Staten Island, New York, licensed in New York (291470) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1669866158
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. ELLIS ENABOSICredential: M.D.
Location Address455 JERSEY STStaten Island, NY 10301-2976
Mailing Address1434 Williamsbridge Rd Fl 2Bronx, NY 10461-2507 · (718) 618-0401 · Fax (347) 479-1303
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 24, 2015
Last NPPES UpdateJanuary 8, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2021
NPI 1669866158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NY · 291470
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 291470 (NY)
455 JERSEY ST, Staten Island, NY 10301

Secondary Practice Locations 2

Location 1460 N Maple AveEast Orange, NJ 07017-4619 · Phone (973) 280-9600
Location 22015 Grand ConcourseBronx, NY 10453-4303 · Phone (718) 299-7295 · Fax (718) 618-6797

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. Ellis Enabosi M.d. 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 ID3274890272
PECOS Enrollment IDI20171129002536
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 8

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
4,658 services658 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
2,334 services311 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.
334 services70 patients
Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304
An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.
321 services282 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
265 services230 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.
133 services65 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10301 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
455 JERSEY ST
STATEN ISLAND, NY 10301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669866158, enumerated as an "individual" on March 24, 2015.

The provider is located at 455 JERSEY ST STATEN ISLAND, NY 10301 and the phone number is (187) 524-5611.

Internal Medicine with taxonomy code 207R00000X.