AMY ELLSWORTH
NPI 1922332998
Nurse Practitioner - Family in Santa Ana, CA
About Amy Ellsworth NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMY ELLSWORTH (NPI 1922332998) is an individual family provider in Santa Ana, California, licensed in Virginia (0024168309) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS and is a graduate of University Of Utah School Of Medicine (2007).
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 and accepts Medicare assignment
Amy Ellsworth 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.
Medicare Billing Reassignments
3Medicare enrollment records show Amy Ellsworth reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Provo, UT 84606
- Reassigned Medicare billing, Utah enrollment
- 84 clinicians in this Medicare group
Sandy, UT 84093
- Reassigned Medicare billing, Utah enrollment
- Medicare enrollment name: Healthy Mindset Intl Inc
- 6 clinicians in this Medicare group
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 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 92705 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 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Amy Ellsworth's NPI number?
The NPI number for Amy Ellsworth is 1922332998. It was assigned to this individual provider in the NPPES registry on September 24, 2009.
Where is Amy Ellsworth located?
Amy Ellsworth practices at 1751 E Garry Ave, Santa Ana, CA 92705. The listed phone number is (877) 896-7350.
What is Amy Ellsworth's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Amy Ellsworth enrolled in Medicare?
Yes. Amy Ellsworth 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.
Which organizations bill Medicare for Amy Ellsworth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amy Ellsworth reassigns Medicare benefits to 3 organizations: Health Clinics Of Utah (Provo, UT), Healthy Mind Set Intl Inc (Sandy, UT) and University Of Utah Adult Services (Salt Lake City, UT). 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 Amy Ellsworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Amy Ellsworth accept?
Health plans from Blue Cross Blue Shield of North Dakota list Amy Ellsworth 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 Amy Ellsworth was last updated on April 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Amy Ellsworth · NPI 1922332998
Family physician in Santa Ana, California. Individual provider, active in the CMS NPPES registry since September 24, 2009.
## Identity
- **NPI:** 1922332998 (Entity type: Individual)
- **Enumerated:** September 24, 2009
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0024168309 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1751 E GARRY AVE, Santa Ana, CA 92705-5814
- **Phone:** (877) 896-7350
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **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): Health Clinics Of Utah (NPI 1982669982, Provo, UT); Healthy Mind Set Intl Inc (NPI 1295351278, Sandy, UT); University Of Utah Adult Services (NPI 1578967345, Salt Lake City, UT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Utah School Of Medicine, class of 2007
## Record status
- **NPPES last updated:** April 24, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1922332998) · Data from the CMS NPPES public registry.