Miss Tadecher Ellis, PA-C is a medicare enrolled "Physical Medicine & Rehabilitation" in Miramar, Florida. Her current practice location is
2724 Sw 84th Ter, Miramar, Florida. You can reach out to her office (for appointments etc.) via phone at
(203) 360-6824.
Miss Tadecher Ellis is licensed to practice in Florida (license number PA9108390) 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 1891199972.
Provider's Profile
Full Name | Miss Tadecher Ellis |
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Gender | Female |
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Speciality | Physical Medicine & Rehabilitation |
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Location | 2724 Sw 84th Ter, Miramar, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1891199972
- Provider Enumeration Date: 10/17/2014
- Last Update Date: 06/06/2022
Medicare PECOS Information:
- PECOS PAC ID: 2961725940
- Enrollment ID: I20141223001976
Medical Identifiers
Medical identifiers for Miss Tadecher Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1891199972 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | PA9108390 (Florida) | Secondary |
208100000X | Physical Medicine & Rehabilitation | PA9108390 (Florida) | Primary |
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. Miss Tadecher 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 |
Miss Tadecher Ellis, PA-C 2724 Sw 84th Ter, Miramar, FL 33025-2962 Ph: () - | Miss Tadecher Ellis, PA-C 2724 Sw 84th Ter, Miramar, FL 33025-2962 Ph: (203) 360-6824 |
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