Ashley Detzner Ellenberger, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Indianapolis, Indiana. Her current practice location is
550 University Blvd Rm 641, Indianapolis, Indiana. You can reach out to her office (for appointments etc.) via phone at
(317) 944-1816.
Ashley Detzner Ellenberger is licensed to practice in Indiana (license number ) 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 1417584418.
Physician's Profile
Full Name | Ashley Detzner Ellenberger |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 550 University Blvd Rm 641, Indianapolis, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417584418
- Provider Enumeration Date: 03/27/2020
- Last Update Date: 05/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 8022430917
- Enrollment ID: I20200623001226
Medical Identifiers
Medical identifiers for Ashley Detzner Ellenberger such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417584418 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0202X | Radiology - Diagnostic Radiology | 01096035A (Indiana) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (Indiana) | Primary |
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. Ashley Detzner Ellenberger 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 |
Ashley Detzner Ellenberger, MD 8414 Naab Rd, Indianapolis, IN 46260-1972 Ph: () - | Ashley Detzner Ellenberger, MD 550 University Blvd Rm 641, Indianapolis, IN 46202-5149 Ph: (317) 944-1816 |
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