KELLEY LYNNE ELLIS NP
NPI 1790322576
Nurse Practitioner in Ann Arbor, MI
About Kelley Lynne Ellis Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY LYNNE ELLIS NP (NPI 1790322576) is an individual nurse practitioner in Ann Arbor, Michigan, licensed in Michigan (4704290179) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelley Lynne Ellis Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Kelley Ellis reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Ann Arbor, MI 48109
- Reassigned Medicare billing, Michigan enrollment
- 507 clinicians in this Medicare group
Southfield, MI 48034
- Reassigned Medicare billing, Michigan enrollment
- 407 clinicians in this Medicare group
Waterford, MI 48328
- Reassigned Medicare billing, Michigan enrollment
- 139 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ANN ARBOR, MI 48109
ANN ARBOR, MI 48109
ANN ARBOR, MI 48109
ANN ARBOR, MI 48109
ANN ARBOR, MI 48109
ANN ARBOR, MI 48109
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 Kelley Ellis's NPI number?
The NPI number for Kelley Ellis is 1790322576. It was assigned to this individual provider in the NPPES registry on November 29, 2019.
Where is Kelley Ellis located?
Kelley Ellis practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.
What is Kelley Ellis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Kelley Ellis enrolled in Medicare?
Yes. Kelley Ellis is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelley Ellis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Ellis reassigns Medicare benefits to 3 organizations: Regents Of The University Of Michigan (Ann Arbor, MI), Vhs Physicians Of Michigan (Southfield, MI) and Sjmh Medical Practice-Smhc (Waterford, MI). 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 Kelley Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelley Ellis accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Kelley 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 Kelley Ellis was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Kelley Lynne Ellis, NP · NPI 1790322576
Nurse Practitioner physician in Ann Arbor, Michigan. Individual provider, active in the CMS NPPES registry since November 29, 2019.
## Identity
- **NPI:** 1790322576 (Entity type: Individual)
- **Enumerated:** November 29, 2019
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 4704290179 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109-5000
- **Phone:** (734) 936-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Regents Of The University Of Michigan (NPI 1447275102, Ann Arbor, MI); Vhs Physicians Of Michigan (NPI 1073827101, Southfield, MI); Sjmh Medical Practice-Smhc (NPI 1366644551, Waterford, MI) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790322576) · Data from the CMS NPPES public registry.