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DANIELLE IMANI ELLIS MD
NPI 1740817469
Surgery in Medford, MA

Active since March 24, 2020PECOS Enrolled
75 RIVERSIDE AVE STE 4, MEDFORD, MA 02155(781) 396-8224 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 26, 2026, Mar 24, 2020 (2 updates tracked since 2020).

About Danielle Imani Ellis Md NPPES

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

DANIELLE IMANI ELLIS MD (NPI 1740817469) is an individual surgery provider in Medford, Massachusetts, licensed in Massachusetts (295571) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1740817469
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDANIELLE IMANI ELLISCredential: MD
Location Address75 RIVERSIDE AVE STE 4Medford, MA 02155-4600
Mailing AddressPo Box 24300New York, NY 10087-4300 · (781) 744-8771
Phone(781) 396-8224
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 24, 2020
Last NPPES UpdateAugust 26, 20262 updates tracked since enumeration
NPPES CertifiedAugust 26, 2026
✔ NPI 1740817469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MA · 295571
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
75 RIVERSIDE AVE STE 4, Medford, MA 02155
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Secondary Practice Locations 2

Location 155 Fruit StBoston, MA 02114-2621 · Phone (617) 726-2803
Location 22014 Washington StNewton, MA 02462-1607 · Phone (617) 726-2803

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Danielle Imani Ellis Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224598636
PECOS Enrollment IDI20260904001499
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 Reassignment

Medicare enrollment records show Danielle Ellis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beth Israel Lahey Health Specialty Care, Inc.
7.8 mi
Urology
41 MALL RD LAHEY HOSPITAL & MEDICAL CENTER
Burlington, MA 01805
  • Reassigned Medicare billing, Massachusetts enrollment
  • 477 clinicians in this Medicare group
NPI 1427161660 (978) 927-0714

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02155 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
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.

WINCHESTER WOUND CARE SPECIALISTS PLLC
Internal Medicine
75 RIVERSIDE AVE STE 4
MEDFORD, MA 02155
Middlesex County (781) 756-7095

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 Danielle Ellis's NPI number?

The NPI number for Danielle Ellis is 1740817469. It was assigned to this individual provider in the NPPES registry on March 24, 2020.

Where is Danielle Ellis located?

Danielle Ellis practices at 75 Riverside Ave Ste 4, Medford, MA 02155. The listed phone number is (781) 396-8224.

What is Danielle Ellis's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Danielle Ellis enrolled in Medicare?

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

Which organization bills Medicare for Danielle Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Danielle Ellis reassigns Medicare benefits to Beth Israel Lahey Health Specialty Care, Inc. (Burlington, MA). 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 Danielle Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Danielle Ellis was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.