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LESLIE R ELLIS M.D.
NPI 1679542765
Pediatrics - Neonatal-Perinatal Medicine in Louisville, KY

Active since March 14, 2006PECOS Enrolled
4123 DUTCHMANS LN STE 301, LOUISVILLE, KY 40207(502) 896-2500(502) 896-2527 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 14, 2021, Apr 5, 2021, Jan 12, 2021 and 2 more (5 updates tracked since 2016).

About Leslie R Ellis M.d. NPPES

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

LESLIE R ELLIS M.D. (NPI 1679542765) is an individual neonatal-perinatal medicine provider in Louisville, Kentucky, licensed in Kentucky (35733) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679542765
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameLESLIE R ELLISCredential: M.D.
Location Address4123 DUTCHMANS LN STE 301Louisville, KY 40207-4721
Mailing AddressPo Box 776879Chicago, IL 60677-6879 · (502) 272-5395 · Fax (502) 272-5339
Phone(502) 896-2500
Fax(502) 896-2527
Sole ProprietorNo
Enumeration DateMarch 14, 2006
Last NPPES UpdateSeptember 14, 20215 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2021
✔ NPI 1679542765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in KY · 35733
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
4123 DUTCHMANS LN STE 301, Louisville, KY 40207
Open in Google Maps ↗

Other Identifiers 4

Other000000744501KY · Anthem- Kcns
Medicaid200439570IN
Other50035433KY · Passport- Kcns
Medicaid64067267KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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)

Leslie R Ellis M.d. 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 Reassignments

2

Medicare enrollment records show Leslie Ellis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Medical Associates, Inc.
3.6 mi
Sports Medicine
1951 BISHOP LN FL 4
Louisville, KY 40218
  • Reassigned Medicare billing, Kentucky enrollment
  • 1,896 clinicians in this Medicare group
NPI 1386904647 (502) 588-9490
Norton Children's Medical Group, LLC
5.9 mi
Neurology with Special Qualifications in Child Neurology
4803 OLYMPIA PARK PLZ STE 1100
Louisville, KY 40241
  • Reassigned Medicare billing, Indiana and Kentucky enrollments
  • Medicare enrollment name: Norton Childrens Medical Group LLC
  • Also billed through NPI 1013559921 (Kentucky)
  • 94 clinicians in this Medicare group
NPI 1134760796 (502) 272-5336

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

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

MRS. EMILY STORMS SHUTT APRN
Nurse Practitioner (Acute Care)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 891-8300
SYNTHIA HEFFERNAN APRN
Nurse Practitioner
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
CRYSTAL D CASSITY O.T.R.L.
Occupational Therapist (Pediatrics)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
KETAN C MEHTA M.D.
Pediatrics (Neonatal-Perinatal Medicine)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
KIMBERLY DAWN WALKER DNP, RN, CPNP-PC
Nurse Practitioner
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
JENNIFER L KIEL APRN
Nurse Practitioner (Family)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
MRS. SHERRI LYNN LAMMERDING APRN, NNP-BC
Nurse Practitioner (Neonatal)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500
CYNTHIA SUE CRABTREE D.O.
Pediatrics (Neonatal-Perinatal Medicine)
4123 DUTCHMANS LN STE 301
LOUISVILLE, KY 40207
Jefferson County (502) 896-2500

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 Leslie Ellis's NPI number?

The NPI number for Leslie Ellis is 1679542765. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Leslie Ellis located?

Leslie Ellis practices at 4123 Dutchmans Ln Ste 301, Louisville, KY 40207. The listed phone number is (502) 896-2500.

What is Leslie Ellis's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Leslie Ellis enrolled in Medicare?

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

Which organizations bill Medicare for Leslie Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leslie Ellis reassigns Medicare benefits to 2 organizations: Community Medical Associates, Inc. (Louisville, KY) and Norton Children's Medical Group, LLC (Louisville, KY). Each 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 Leslie Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Leslie Ellis accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Leslie 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 Leslie Ellis was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.