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ELIE C ELLENBERG MD
NPI 1942839071
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since April 01, 2020PECOS Enrolled
1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 257-8000 Get Directions Write a Review

NPPES record last updated: March 24, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 24, 2021, Apr 1, 2020 (2 updates tracked since 2020).

About Elie C Ellenberg Md NPPES

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

ELIE C ELLENBERG MD (NPI 1942839071) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Ann Arbor, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1942839071
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameELIE C ELLENBERGCredential: MD
Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016
Mailing Address934 W Huron StAnn Arbor, MI 48103-4216 · (248) 514-1344
Phone(314) 257-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 1, 2020
Last NPPES UpdateMarch 24, 20212 updates tracked since enumeration
NPPES CertifiedMarch 24, 2021
✔ NPI 1942839071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1201 S GRAND BLVD, Saint Louis, MO 63104
Open in Google Maps ↗

Secondary Practice Location 1

Location 11500 E Medical Center DrAnn Arbor, MI 48109-5000 · Phone (734) 936-4000

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elie C Ellenberg Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911308002
PECOS Enrollment IDI20260709004608
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.

Medicare Billing Reassignment

Medicare enrollment records show Elie Ellenberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Holy Cross Hospital Inc
1,040 mi
Internal Medicine
4725 N FEDERAL HIGHWAY, HCMG BILLING DEPARTMENT
Ft. Lauderdale, FL 33308
  • Reassigned Medicare billing, Florida enrollment
  • 393 clinicians in this Medicare group
NPI 1467401877 (954) 351-4702

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DOUG LONGO APRN
Nurse Practitioner (Acute Care)
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
JOHN JOSEPH HOUSER
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
NABIHA NOOR SHAMSHUDDIN MD
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
AMAN PATEL
Radiology (Diagnostic Radiology)
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
MS. KEELEY FERRELL RYAN PA-C
Physician Assistant
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-1320
PATRICK SWEENEY
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
DR. SHAMEELA NASRULLAH KHIMANI MD
Pediatrics
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3239
IBRAHIM SHAMASNEH M.D.
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000

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 Elie Ellenberg's NPI number?

The NPI number for Elie Ellenberg is 1942839071. It was assigned to this individual provider in the NPPES registry on April 1, 2020.

Where is Elie Ellenberg located?

Elie Ellenberg practices at 1201 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 257-8000.

What is Elie Ellenberg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Elie Ellenberg enrolled in Medicare?

Yes. Elie Ellenberg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elie Ellenberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elie Ellenberg reassigns Medicare benefits to Holy Cross Hospital Inc (Ft. Lauderdale, FL). The 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 Elie Ellenberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elie Ellenberg accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 2 other insurers list Elie Ellenberg 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 Elie Ellenberg was last updated on March 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.