Philip Lee Ellis, PHD in Grand Rapids, MI - Medicare Psychologist Provider

Philip Lee Ellis, PHD is a medicare enrolled "Psychologist" provider in Grand Rapids, Michigan. His current practice location is 300 68th St Se, Grand Rapids, Michigan. You can reach out to his office (for appointments etc.) via phone at (616) 455-5000.

Philip Lee Ellis is licensed to practice in Michigan (license number 6301005230) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073549911.

Contact Information

	Philip Lee Ellis, PHD
	300 68th St Se, Grand Rapids, MI 49548-6927
	(616) 455-5000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Philip Lee Ellis
Gender	Male
Speciality	Psychologist
Location	300 68th St Se, Grand Rapids, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073549911
Provider Enumeration Date: 06/23/2006
Last Update Date: 09/19/2017

Medicare PECOS Information:

PECOS PAC ID: 6305905225
Enrollment ID: I20081107000063

Medical Identifiers

Medical identifiers for Philip Lee Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073549911	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	6301005230 (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. Philip Lee Ellis allows following entities to bill medicare on his behalf.

Entity Name	Adaptive Counseling And Case Management Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588906119 PECOS PAC ID: 8921248139 Enrollment ID: O20130711000836

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. Philip Lee 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
Philip Lee Ellis, PHD 125 S Park St, Ste 325, Traverse City, MI 49684-3608 Ph: (231) 715-8466	Philip Lee Ellis, PHD 300 68th St Se, Grand Rapids, MI 49548-6927 Ph: (616) 455-5000

Reviews and Comments

Psychologist in Grand Rapids, MI

Dynetta Clark, MA, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 805 Leonard St Ne, Grand Rapids, MI 49503 Phone: 616-451-2021 Fax: 616-774-1001
Mrs. Amy E Pugh, PSYD Psychologist Medicare: Medicare Enrolled Practice Location: 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503 Phone: 616-267-2830 Fax: 616-267-9024
Meghan Cytacki-lewis, MA, TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 333 Bridge St Nw Ste 1120, Grand Rapids, MI 49504 Phone: 616-805-3660
Michelle Marie Muenzenmeyer, LLP, CHMC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2020 Raybrook St Se Ste 102-1, Grand Rapids, MI 49546 Phone: 616-795-0900 Fax: 616-795-0899
Jehricole Olenzuk, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 829 Forest Hill Ave Se, Grand Rapids, MI 49546 Phone: 616-949-2410
Adrian Hernandez, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 360 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49506 Phone: 616-805-3660
Marcia Hollingsworth, EDD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1870 Leonard Ne, Grand Rapids, MI 49505 Phone: 616-956-1122 Fax: 616-956-8033

Philip Lee Ellis, PHD - Medicare Psychologist in Grand Rapids, MI