Dr Zachary Dimitri Ellis, DO - Medicare Internal Medicine in Tupelo, MS

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Dr Zachary Dimitri Ellis, DO is a medicare enrolled "Internal Medicine" physician in Tupelo, Mississippi. His current practice location is 830 S Gloster St, Tupelo, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 377-2539.

Dr Zachary Dimitri Ellis is licensed to practice in Mississippi (license number 33630) 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 1124778873.

Contact Information

Dr Zachary Dimitri Ellis, DO
830 S Gloster St,
Tupelo, MS 38801-4996
(662) 377-2539
(662) 377-2920

Map and Direction




Physician's Profile

Full NameDr Zachary Dimitri Ellis
GenderMale
SpecialityInternal Medicine
Location830 S Gloster St, Tupelo, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124778873
  • Provider Enumeration Date: 03/25/2022
  • Last Update Date: 07/07/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7618358789
  • Enrollment ID: I20241209001845

Medical Identifiers

Medical identifiers for Dr Zachary Dimitri Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124778873NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 33630 (Mississippi)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. Dr Zachary Dimitri Ellis allows following entities to bill medicare on his behalf.
Entity NameMississippi Ltac Holdings, Llc
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1144983685
PECOS PAC ID: 5395135677
Enrollment ID: O20220809001499

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 Zachary Dimitri 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 AddressPractice Location Address
Dr Zachary Dimitri Ellis, DO
808 Varsity Dr,
Tupelo, MS 38801-4613

Ph: (662) 377-3204		Dr Zachary Dimitri Ellis, DO
830 S Gloster St,
Tupelo, MS 38801-4996

Ph: (662) 377-2539

Reviews and Comments


Internal Medicine Doctors in Tupelo, MS

Dr. Marcus Louis Britton, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1542 Medical Park Cir, Tupelo, MS 38801
Phone: 662-844-4711    
John O Phillips, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 589 Garfield St Ste 201, Tupelo, MS 38801
Phone: 662-680-5565    Fax: 662-680-5654
Dr. Michael Ted Boler Jr., D.O.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801
Phone: 662-620-6800    Fax: 662-620-6950
Christy Tucker Oswalt, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 65 S Thomas St, Tupelo, MS 38801
Phone: 662-842-7870    Fax: 662-842-7873
Vernon A Rayford, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 845 S Madison St, Tupelo, MS 38801
Phone: 662-377-5930    
Dr. Frankie Edward Stanley, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 302 S Spring St, Tupelo, MS 38804
Phone: 662-205-0098    Fax: 662-495-4079
Stephen T Amann, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 589 Garfield St Ste 201, Tupelo, MS 38801
Phone: 662-680-5565    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.