KENNETH ROBERT ELLISON PA
NPI 1831122803
Physician Assistant - Medical in Fort Walton Beach, FL

Q: What is Kenneth Ellison's NPI number?

The NPI number for Kenneth Ellison is 1831122803. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Q: What is Kenneth Ellison's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Ellison was last updated on January 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1032 MAR WALT DR, SUITE 250, FORT WALTON BEACH, FL 32547(850) 863-3463(850) 315-6051 Get Directions Write a Review

NPPES record last updated: January 14, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Kenneth Robert Ellison Pa NPPES

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

KENNETH ROBERT ELLISON PA (NPI 1831122803) is an individual medical provider in Fort Walton Beach, Florida, licensed in Florida (9106823) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Twin Cities Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1831122803

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameKENNETH ROBERT ELLISONCredential: PA

Location Address1032 MAR WALT DR, SUITE 250Fort Walton Beach, FL 32547-6661

Mailing Address1032 Mar Walt Dr, Suite 250Fort Walton Beach, FL 32547-6661 · (850) 863-3463 · Fax (850) 315-6051

Phone(850) 863-3463

Fax(850) 315-6051

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateJuly 10, 2006

Last NPPES UpdateJanuary 14, 2022

✔ NPI 1831122803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in FL · 9106823

1032 MAR WALT DR, Fort Walton Beach, FL 32547

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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

Kenneth Robert Ellison Pa 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 ID7113928805

PECOS Enrollment IDI20121114000369

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 2

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

44 services36 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

40 services40 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Twin Cities Hospital

Acute Care Hospitals · Niceville, FL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number100054

Location2190 Hwy 85 NNiceville, FL 32578 · Okaloosa County

Emergency services

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100223

Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County

Emergency services Birthing friendly

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Provide Patients Electronic Access to Their Health Information

100%53 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 15

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

NIKKOLE NUNEZ TOWN

Nurse Practitioner (Family)

1032 MAR WALT DR
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 863-8260

ERIC L SANDWITH MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

1032 MAR WALT DR, SUITE 230
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 862-3194

BARNETT FACIAL PLASTIC & RECONSTRUCTIVE SURGERY, PA.

Otolaryngology (Plastic Surgery within the Head & Neck)

1032 MAR WALT DR, SUITE 100
FORT WALTON BEACH, FL 32547

Okaloosa County (504) 914-7696

WHITE SANDS PODIATRY LLC

Podiatrist (Foot & Ankle Surgery)

1032 MAR WALT DR, STE 100
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 622-1607

EMERALD COAST EAR, NOSE, THROAT & ALLERGIES, P.A.

Health Maintenance Organization

1032 MAR WALT DR, SUITE 100
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 796-1368

TIMOTHY M BRADLEY,MD SC

Plastic Surgery

1032 MAR WALT DR, SUITE 240
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 533-0865

BEACH ORTHOPAEDIC & SPORTS MEDICINE CLINIC, PA

Orthopaedic Surgery

1032 MAR WALT DR, SUITE 210
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 664-5633

JOSEPH DANIEL SIEFKER M.D.

Otolaryngology (Otolaryngic Allergy)

1032 MAR WALT DR, SUITE 100
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 796-1368

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 Kenneth Ellison's NPI number?

The NPI number for Kenneth Ellison is 1831122803. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Kenneth Ellison located?

Kenneth Ellison practices at 1032 Mar Walt Dr Suite 250, Fort Walton Beach, FL 32547. The listed phone number is (850) 863-3463.

What is Kenneth Ellison's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kenneth Ellison enrolled in Medicare?

Yes. Kenneth Ellison 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.

What insurance does Kenneth Ellison accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama and Oscar Health Maintenance Organization of Florida list Kenneth Ellison 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.

Is Kenneth Ellison affiliated with any hospitals?

According to CMS data, Kenneth Ellison is affiliated with Hca Florida Twin Cities Hospital and Hca Florida Fort Walton-Destin Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Ellison was last updated on January 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.