SUSAN ELLIS PMHNP
NPI 1750706800
Nurse Practitioner - Psychiatric/Mental Health in Roseburg, OR

Q: What is Susan Ellis's NPI number?

The NPI number for Susan Ellis is 1750706800. It was assigned to this individual provider in the NPPES registry on February 26, 2014.

Q: What is Susan Ellis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Susan Ellis was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since February 26, 2014PECOS EnrolledAccepts Medicare Assignment

621 W MADRONE ST, ROSEBURG, OR 97470(541) 492-4550(541) 492-4556 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 6, 2024, Dec 28, 2021, Sep 16, 2019 and 1 more (4 updates tracked since 2019).

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About Susan Ellis Pmhnp NPPES

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

SUSAN ELLIS PMHNP (NPI 1750706800) is an individual psychiatric/mental health provider in Roseburg, Oregon, licensed in Oregon (202114835NP-PP) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS, is affiliated with Mercy Medical Center, and is a graduate of University Of Arizona College Of Medicine (2016).

NPPES Registry Identity

NPI1750706800

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSUSAN ELLISCredential: PMHNP

Location Address621 W MADRONE STRoseburg, OR 97470-3090

Mailing AddressPo Box 1121Roseburg, OR 97470-0254 · (541) 672-2691

Phone(541) 492-4550

Fax(541) 492-4556

Sole ProprietorNo

Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2016

Enumeration DateFebruary 26, 2014

Last NPPES UpdateSeptember 29, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2025

✔ NPI 1750706800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in OR · 202114835NP-PP

621 W MADRONE ST, Roseburg, OR 97470

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

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

Susan Ellis Pmhnp 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 ID5294954525

PECOS Enrollment IDI20220106000139

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

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

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

176 services58 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Medical Center

Acute Care Hospitals · Roseburg, OR

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number380027

Location2700 NW Stewart ParkwayRoseburg, OR 97471 · Douglas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97470 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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 20

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

WILLIAM F SHOBE JR. LMFT

Marriage & Family Therapist