Kathleen Dunlevy Ellis, PA-C in Mishawaka, IN - Medicare Physician Assistant

Kathleen Dunlevy Ellis, PA-C is a medicare enrolled "Physician Assistant - Surgical" in Mishawaka, Indiana. Her current practice location is 611 E Douglas Rd Ste 208, Mishawaka, Indiana. You can reach out to her office (for appointments etc.) via phone at (317) 714-8752.

Kathleen Dunlevy Ellis is licensed to practice in Indiana (license number 10004107A) 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 1891570545.

Contact Information

	Kathleen Dunlevy Ellis, PA-C
	611 E Douglas Rd Ste 208, Mishawaka, IN 46545-1465
	(317) 714-8752
	Not Available

Map and Direction

Provider's Profile

Full Name	Kathleen Dunlevy Ellis
Gender	Female
Speciality	Physician Assistant - Surgical
Location	611 E Douglas Rd Ste 208, Mishawaka, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891570545
Provider Enumeration Date: 08/30/2023
Last Update Date: 10/03/2023

Medicare PECOS Information:

PECOS PAC ID: 5890140701
Enrollment ID: I20231012003358

Medical Identifiers

Medical identifiers for Kathleen Dunlevy Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891570545	NPI	-	NPPES
300080410	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AS0400X	Physician Assistant - Surgical	10004107A (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. Kathleen Dunlevy 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
Kathleen Dunlevy Ellis, PA-C 707 Cedar St Ste 405, South Bend, IN 46617-2059 Ph: () -	Kathleen Dunlevy Ellis, PA-C 611 E Douglas Rd Ste 208, Mishawaka, IN 46545-1465 Ph: (317) 714-8752

Reviews and Comments

Physician Assistant Nurses in Mishawaka, IN

Collins Abere, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-335-5000
Duane M Wampler, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1802 Day Rd, Mishawaka, IN 46545 Phone: 574-204-7200 Fax: 574-252-0633
Mrs. Diana E Perez - Solano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 611 E Douglas Rd Ste 207, Mishawaka, IN 46545 Phone: 574-335-6850 Fax: 574-335-0849
Emily Elston, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 505 W Cleveland Rd, Mishawaka, IN 46545 Phone: 574-235-3135
David Eugene Fellows, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000
Emily Grace Gouker, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 270 E Day Rd Ste 280, Mishawaka, IN 46545 Phone: 574-271-0268 Fax: 574-271-0395
Mr. Tyler Stephen Clutter, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-523-3160 Fax: 574-523-3221

Kathleen Dunlevy Ellis, PA-C - Medicare Physician Assistant in Mishawaka, IN