DR. KATHLEEN ELLIS PHD, LADC, LPC
NPI 1679902316
Counselor - Addiction (Substance Use Disorder) in New London, CT
About Dr. Kathleen Ellis Phd, Ladc, Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KATHLEEN ELLIS PHD, LADC, LPC (NPI 1679902316) is an individual addiction (substance use disorder) provider in New London, Connecticut, licensed in Connecticut (000903) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kathleen Ellis Phd, Ladc, Lpc 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.
Medicare Billing Reassignment
Medicare enrollment records show Kathleen Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New Haven, CT 06510
- Reassigned Medicare billing, Connecticut enrollment
- Medicare enrollment name: Northeast Medical Group Inc
- 1,824 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
NEW LONDON, CT 06320
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 Kathleen Ellis's NPI number?
The NPI number for Kathleen Ellis is 1679902316. It was assigned to this individual provider in the NPPES registry on November 4, 2013.
Where is Kathleen Ellis located?
Kathleen Ellis practices at 365 Montauk Ave, New London, CT 06320. The listed phone number is (860) 271-4271.
What is Kathleen Ellis's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
Is Kathleen Ellis enrolled in Medicare?
Yes. Kathleen Ellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kathleen Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Ellis reassigns Medicare benefits to Mill Hill Medical Consultants Inc (New Haven, CT). The 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 Kathleen Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kathleen Ellis accept?
Health plans from Anthem Blue Cross and Blue Shield list Kathleen 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 Kathleen Ellis was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Dr. Kathleen Ellis, PHD, LADC, LPC · NPI 1679902316
Addiction (Substance Use Disorder) provider in New London, Connecticut. Individual provider, active in the CMS NPPES registry since November 4, 2013.
## Identity
- **NPI:** 1679902316 (Entity type: Individual)
- **Enumerated:** November 4, 2013
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** 000903 (Connecticut)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 365 MONTAUK AVE, New London, CT 06320-4700
- **Phone:** (860) 271-4271 · **Fax:** (860) 444-5107
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mill Hill Medical Consultants Inc (NPI 1952624769, New Haven, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** September 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679902316) · Data from the CMS NPPES public registry.