Ms Kerri A Ellis, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Grafton, Massachusetts. Her current practice location is
76 Follette St, Grafton, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(508) 954-7420.
Ms Kerri A Ellis is licensed to practice in Massachusetts (license number 233757) 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 1003913567.
Provider's Profile
| Full Name | Ms Kerri A Ellis |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 76 Follette St, Grafton, Massachusetts |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003913567
- Provider Enumeration Date: 09/19/2006
- Last Update Date: 08/26/2026
Medicare PECOS Information:
- PECOS PAC ID: 1557367430
- Enrollment ID: I20061017000331
Medical Identifiers
Medical identifiers for Ms Kerri A Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003913567 | NPI | - | NPPES |
| 110073123A | Medicaid | MA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | 233757 (Massachusetts) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 233757 (Massachusetts) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 233757 (Massachusetts) | 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. Ms Kerri A Ellis allows following entities to bill medicare on her behalf.
| Entity Name | Umass Memorial Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760445373
PECOS PAC ID: 4284539891
Enrollment ID: O20040113000267 |
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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. Ms Kerri A 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 |
|---|
Ms Kerri A Ellis, NP
76 Follette St,
Grafton, MA 01519-1022
Ph: (508) 954-7420 | Ms Kerri A Ellis, NP
76 Follette St,
Grafton, MA 01519-1022
Ph: (508) 954-7420 |
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