Dr Mark Ellis, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Draper, Utah. He graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice San Carlos Apache Healthcare Corporation, Cobre Valley Regional Medical Center and his current practice location is
12592 S 150 E, Draper, Utah. You can reach out to his office (for appointments etc.) via phone at
(713) 377-2167.
Dr Mark Ellis is licensed to practice in Arizona (license number 0821) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1972897080.
Healthcare Provider's Profile
| Full Name | Dr Mark Ellis |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 13 Years |
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| Location | 12592 S 150 E, Draper, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Mark Ellis graduated from medical school in 2011
NPI Data:
- NPI Number: 1972897080
- Provider Enumeration Date: 06/06/2011
- Last Update Date: 05/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 5294957320
- Enrollment ID: I20171116000146
Medical Identifiers
Medical identifiers for Dr Mark Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1972897080 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0000X | Podiatrist - Sports Medicine | 10105797-0501 (Utah) | Secondary |
| 213ER0200X | Podiatrist - Radiology | 10105797-0501 (Utah) | Secondary |
| 213EP0504X | Podiatrist - Public Medicine | 10105797-0501 (Utah) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 10105797-0501 (Utah) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 0821 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| San Carlos Apache Healthcare Corporation | 0648580597 | 112 |
| Cobre Valley Regional Medical Center | 0648181693 | 27 |
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 Mark Ellis allows following entities to bill medicare on his behalf.
| Provider Name | Tuba City Regional Health Care Corporation |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1548294424
PECOS PAC ID: 4284542531
Enrollment ID: O20031105000107 |
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| Provider Name | San Carlos Apache Healthcare Corporation |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1265813075
PECOS PAC ID: 0648580597
Enrollment ID: O20151105002091 |
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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. Dr Mark 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 |
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Dr Mark Ellis, DPM
5994 S Hospital Dr,
Globe, AZ 85501-9462
Ph: () - | Dr Mark Ellis, DPM
12592 S 150 E,
Draper, UT 84020-8611
Ph: (713) 377-2167 |
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