Paula Lou Ellsworth, NP is a medicare enrolled "Nurse Practitioner - Family" in Ithaca, Michigan. Her current practice location is
114 N Main St, Ithaca, Michigan. You can reach out to her office (for appointments etc.) via phone at
(989) 875-4166.
Paula Lou Ellsworth is licensed to practice in Michigan (license number 4704187187) 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 1255680211.
Provider's Profile
| Full Name | Paula Lou Ellsworth |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 114 N Main St, Ithaca, Michigan |
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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: 1255680211
- Provider Enumeration Date: 09/06/2012
- Last Update Date: 09/06/2012
Medicare PECOS Information:
- PECOS PAC ID: 7719139104
- Enrollment ID: I20121211000343
Medical Identifiers
Medical identifiers for Paula Lou Ellsworth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255680211 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 4704187187 (Michigan) | 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. Paula Lou Ellsworth allows following entities to bill medicare on her behalf.
| Entity Name | Sparrow Carson Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598490542
PECOS PAC ID: 7113836701
Enrollment ID: O20040126000046 |
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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. Paula Lou Ellsworth 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 |
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Paula Lou Ellsworth, NP
406 E Elm St,
Carson City, MI 48811-9693
Ph: (989) 584-3131 | Paula Lou Ellsworth, NP
114 N Main St,
Ithaca, MI 48847-1132
Ph: (989) 875-4166 |
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