Petrina Ellis, is a medicare enrolled "Internal Medicine" in Yonkers, New York. Her current practice location is
30 S Broadway Fl 2, Yonkers, New York. You can reach out to her office (for appointments etc.) via phone at
(914) 968-4898.
Petrina Ellis is licensed to practice in New York (license number F349223) 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 1356613574.
Provider's Profile
| Full Name | Petrina Ellis |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Location | 30 S Broadway Fl 2, Yonkers, New York |
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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: 1356613574
- Provider Enumeration Date: 02/03/2012
- Last Update Date: 12/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 9335506096
- Enrollment ID: I20230914000441
Medical Identifiers
Medical identifiers for Petrina Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356613574 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 625326 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN253453 (Georgia) | Secondary |
| 207R00000X | Internal Medicine | F349223 (New York) | 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. Petrina Ellis allows following entities to bill medicare on her behalf.
| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20200115001292 |
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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. Petrina 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 |
|---|
Petrina Ellis,
30 S Broadway Fl 2,
Yonkers, NY 10701-3708
Ph: () - | Petrina Ellis,
30 S Broadway Fl 2,
Yonkers, NY 10701-3708
Ph: (914) 968-4898 |
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