Mary T Ellis, CNM is a medicare enrolled "Advanced Practice Midwife" in Hammond, Indiana. Her current practice location is
6920 Indianapolis Blvd, Hammond, Indiana. You can reach out to her office (for appointments etc.) via phone at
(219) 763-8112.
Mary T Ellis is licensed to practice in Michigan (license number 4704272662) 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 1306173786.
Provider's Profile
Full Name | Mary T Ellis |
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Gender | Female |
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Speciality | Advanced Practice Midwife |
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Location | 6920 Indianapolis Blvd, Hammond, 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: 1306173786
- Provider Enumeration Date: 11/05/2009
- Last Update Date: 05/27/2014
Medicare PECOS Information:
- PECOS PAC ID: 7315164381
- Enrollment ID: I20140814002453
Medical Identifiers
Medical identifiers for Mary T Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306173786 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367A00000X | Advanced Practice Midwife | 4704272662 (Michigan) | 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. Mary T 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 |
Mary T Ellis, CNM Po Box 1430, Portage, IN 46368-9230 Ph: (219) 763-8112 | Mary T Ellis, CNM 6920 Indianapolis Blvd, Hammond, IN 46324-2206 Ph: (219) 763-8112 |
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