Patricia Jane Ellis, PHD is a medicare enrolled "Psychologist" provider in Ripon, Wisconsin. Her current practice location is
845 Parkside St, Ripon, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 926-4200.
Patricia Jane Ellis is licensed to practice in Wisconsin (license number 3215-57) 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 1346414059.
Healthcare Provider's Profile
| Full Name | Patricia Jane Ellis |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 845 Parkside St, Ripon, Wisconsin |
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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: 1346414059
- Provider Enumeration Date: 04/15/2008
- Last Update Date: 10/06/2022
Medicare PECOS Information:
- PECOS PAC ID: 5799008009
- Enrollment ID: I20141217001901
Medical Identifiers
Medical identifiers for Patricia Jane Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346414059 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 3215-57 (Wisconsin) | 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. Patricia Jane Ellis allows following entities to bill medicare on her behalf.
| Entity Name | Agnesian Healthcare Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346228541
PECOS PAC ID: 1658289624
Enrollment ID: O20031104000263 |
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| Entity Name | Marshfield Clinic Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952347981
PECOS PAC ID: 2264345206
Enrollment ID: O20031106000590 |
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| Entity Name | Mchs Hospitals Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093221434
PECOS PAC ID: 5698071173
Enrollment ID: O20180208000096 |
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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. Patricia Jane 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 |
|---|
Patricia Jane Ellis, PHD
Ssm Health Fdl Regional Clinic, 1808 W Beltline Hwy,
Madison, WI 53713-2334
Ph: (920) 926-8343 | Patricia Jane Ellis, PHD
845 Parkside St,
Ripon, WI 54971-8505
Ph: (920) 926-4200 |
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