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

Q: 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.

Q: What is Leslie Ellis's specialty?

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

Q: 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 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.

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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

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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 CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

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.

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)