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ELLEN M DETHLOFF NP
NPI 1811106222
Nurse Practitioner in Daytona Beach, FL

Active since May 22, 2007PECOS Enrolled
303 N CLYDE MORRIS BLVD # 8E, COORDINATOR EDUCATION-CLINICAL AFFILIATES, DAYTONA BEACH, FL 32114(386) 425-5800(386) 425-5801 Get Directions Write a Review

NPPES record last updated: April 14, 2014. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Ellen M Dethloff Np NPPES

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

ELLEN M DETHLOFF NP (NPI 1811106222) is an individual nurse practitioner in Daytona Beach, Florida, licensed in Florida (ARNP 9373273) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811106222
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameELLEN M DETHLOFFCredential: NP
Location Address303 N CLYDE MORRIS BLVD # 8E, COORDINATOR EDUCATION-CLINICAL AFFILIATESDaytona Beach, FL 32114-2709
Mailing Address303 N Clyde Morris Blvd # 8e, Coordinator Education-clinical AffiliatesDaytona Beach, FL 32114-2709 · (386) 425-5921
Phone(386) 425-5800
Fax(386) 425-5801
Sole ProprietorNo
Enumeration DateMay 22, 2007
Last NPPES UpdateApril 14, 2014
✔ NPI 1811106222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in FL · ARNP 9373273✔ Licensed in NY · 300456
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
303 N CLYDE MORRIS BLVD # 8E, Daytona Beach, FL 32114
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Other Names 1

Former Name (1)Ellen Gunderson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen M Dethloff Np 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.

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
65 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32114 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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 Ellen Dethloff's NPI number?

The NPI number for Ellen Dethloff is 1811106222. It was assigned to this individual provider in the NPPES registry on May 22, 2007. The provider is also known as Ellen Gunderson.

Where is Ellen Dethloff located?

Ellen Dethloff practices at 303 N Clyde Morris Blvd # 8E Coordinator Education-Clinical Affiliates, Daytona Beach, FL 32114. The listed phone number is (386) 425-5800.

What is Ellen Dethloff's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Ellen Dethloff enrolled in Medicare?

Yes. Ellen Dethloff is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ellen Dethloff was last updated on April 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.