Dr Mark Ellis, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Draper, Utah. He graduated from medical school in 2011 and has 14 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice San Carlos Apache Healthcare Corporation, Cobre Valley Regional Medical Center and his current practice location is
12592 S 150 E, Draper, Utah. You can reach out to his office (for appointments etc.) via phone at
(713) 377-2167.
Dr Mark Ellis is licensed to practice in Arizona (license number 0821) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1972897080.
Healthcare Provider's Profile
Full Name | Dr Mark Ellis |
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Gender | Male |
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Speciality | Podiatry |
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Experience | 14 Years |
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Location | 12592 S 150 E, Draper, Utah |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Mark Ellis graduated from medical school in 2011
NPI Data:
- NPI Number: 1972897080
- Provider Enumeration Date: 06/06/2011
- Last Update Date: 05/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 5294957320
- Enrollment ID: I20171116000146
Medical Identifiers
Medical identifiers for Dr Mark Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972897080 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
213ES0000X | Podiatrist - Sports Medicine | 10105797-0501 (Utah) | Secondary |
213ER0200X | Podiatrist - Radiology | 10105797-0501 (Utah) | Secondary |
213EP0504X | Podiatrist - Public Medicine | 10105797-0501 (Utah) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 10105797-0501 (Utah) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 0821 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
San Carlos Apache Healthcare Corporation | 0648580597 | 116 |
Cobre Valley Regional Medical Center | 0648181693 | 31 |
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. Dr Mark Ellis allows following entities to bill medicare on his behalf.
Provider Name | Tuba City Regional Health Care Corporation |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107 |
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Provider Name | San Carlos Apache Healthcare Corporation |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1265813075 PECOS PAC ID: 0648580597 Enrollment ID: O20151105002091 |
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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. Dr Mark 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 |
Dr Mark Ellis, DPM 5994 S Hospital Dr, Globe, AZ 85501-9462 Ph: () - | Dr Mark Ellis, DPM 12592 S 150 E, Draper, UT 84020-8611 Ph: (713) 377-2167 |
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