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DR. KENYANITA ELLIS D.O.
NPI 1841727716
Pediatrics in Jacksonville, FL

Active since May 22, 2017PECOS Enrolled
12086 FORT CAROLINE RD STE 401, JACKSONVILLE, FL 32225(904) 456-9240(904) 456-9231 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 1, 2023, Jun 18, 2020, May 22, 2017 (3 updates tracked since 2017).

About Dr. Kenyanita Ellis D.o. NPPES

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

DR. KENYANITA ELLIS D.O. (NPI 1841727716) is an individual pediatrics provider in Jacksonville, Florida, licensed in Florida (OS16790) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841727716
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. KENYANITA ELLISCredential: D.O.
Location Address12086 FORT CAROLINE RD STE 401Jacksonville, FL 32225-7640
Mailing Address12086 Fort Caroline Rd Ste 401Jacksonville, FL 32225-7640 · (904) 456-9240 · Fax (904) 456-9231
Phone(904) 456-9240
Fax(904) 456-9231
Sole ProprietorNo
Enumeration DateMay 22, 2017
Last NPPES UpdateMarch 1, 20233 updates tracked since enumeration
NPPES CertifiedMarch 1, 2023
✔ NPI 1841727716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · OS16790
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
12086 FORT CAROLINE RD STE 401, Jacksonville, FL 32225
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Other Identifiers 1

Medicaid106632500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) 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 (PECOS)

Dr. Kenyanita Ellis D.o. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32225 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.

Other Providers at the Same Location NPPES

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

ELLIS PEDIATRICS, PLLC
Pediatrics
12086 FORT CAROLINE RD STE 401
JACKSONVILLE, FL 32225
Duval County (904) 456-9240

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 Kenyanita Ellis's NPI number?

The NPI number for Kenyanita Ellis is 1841727716. It was assigned to this individual provider in the NPPES registry on May 22, 2017.

Where is Kenyanita Ellis located?

Kenyanita Ellis practices at 12086 Fort Caroline Rd Ste 401, Jacksonville, FL 32225. The listed phone number is (904) 456-9240.

What is Kenyanita Ellis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kenyanita Ellis enrolled in Medicare?

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

What insurance does Kenyanita Ellis accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Kenyanita 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 Kenyanita Ellis was last updated on March 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.