Madelyne Ellis, FNP is a medicare enrolled "Nurse Practitioner" in Friendship, Tennessee. Her current practice location is
1159 Walter Taylor Rd, Friendship, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(931) 787-4062.
Madelyne Ellis is licensed to practice in Tennessee (license number 35673) 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 1205655594.
Provider's Profile
| Full Name | Madelyne Ellis |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 1159 Walter Taylor Rd, Friendship, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205655594
- Provider Enumeration Date: 10/04/2024
- Last Update Date: 10/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 6406381599
- Enrollment ID: I20241126003129
Medical Identifiers
Medical identifiers for Madelyne Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205655594 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 35673 (Tennessee) | 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. Madelyne Ellis allows following entities to bill medicare on her behalf.
| Entity Name | Wound Management Specialists Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972150084
PECOS PAC ID: 5193056364
Enrollment ID: O20211105001456 |
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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. Madelyne 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 |
|---|
Madelyne Ellis, FNP
60 Physicians Ln,
Southaven, MS 38671-6122
Ph: () - | Madelyne Ellis, FNP
1159 Walter Taylor Rd,
Friendship, TN 38034-3449
Ph: (931) 787-4062 |
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