Karissa Ann Ellis, DO in Fort Wayne, IN

Karissa Ann Ellis, DO is a medicare enrolled "Pediatrics" physician in Fort Wayne, Indiana. Her current practice location is 1717 S Calhoun St, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 458-2641.

Karissa Ann Ellis is licensed to practice in Indiana (license number 02004850A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134486186.

Contact Information

	Karissa Ann Ellis, DO
	1717 S Calhoun St, Fort Wayne, IN 46802-5257
	(260) 458-2641
	Not Available

Map and Direction

Physician's Profile

Full Name	Karissa Ann Ellis
Gender	Female
Speciality	Pediatrics
Location	1717 S Calhoun St, Fort Wayne, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134486186
Provider Enumeration Date: 04/16/2012
Last Update Date: 08/12/2016

Medicare PECOS Information:

PECOS PAC ID: 7012202831
Enrollment ID: I20240201002423

Medical Identifiers

Medical identifiers for Karissa Ann Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134486186	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	02004850A (Indiana)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Karissa Ann Ellis allows following entities to bill medicare on her behalf.

Entity Name	Grays Harbor County Public Hospital District No 1
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740211028 PECOS PAC ID: 9032017256 Enrollment ID: O20031226000146

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Karissa Ann Ellis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Karissa Ann Ellis, DO 1717 S Calhoun St, Fort Wayne, IN 46802-5257 Ph: (260) 458-2641	Karissa Ann Ellis, DO 1717 S Calhoun St, Fort Wayne, IN 46802-5257 Ph: (260) 458-2641

Reviews and Comments

Pediatrics Doctors in Fort Wayne, IN

Dr. Melissa S Rice, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 11115 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-672-6443 Fax: 260-672-6459
Vaneska Bottino Da Costa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001 Fax: 260-435-9763
Ronald R Hall, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1717 S Calhoun St, Fort Wayne, IN 46802 Phone: 260-458-2641 Fax: 260-969-0007
Mrs. Lindsay M Ligler, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2810 Dupont Commerce Ct, Fort Wayne, IN 46825 Phone: 260-490-7337
Osita Victor Ezeakudo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825 Phone: 260-432-4913 Fax: 260-969-6832
Dr. Michael Philip Dick, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3898 New Vision Dr, Fort Wayne, IN 46845 Phone: 260-425-5750 Fax: 260-425-5755
Pamela Thomas, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7950 W Jefferson Blvd, Suite 210, Fort Wayne, IN 46804 Phone: 260-432-2297 Fax: 260-434-6420

Karissa Ann Ellis, DO - Medicare Pediatrics in Fort Wayne, IN