Dr Lauren Rose Ellis, PSYD is a medicare enrolled "Psychologist" provider in Tabernacle, New Jersey. Her current practice location is
25 Sleepy Hollow Dr, Tabernacle, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(718) 873-4908.
Dr Lauren Rose Ellis is licensed to practice in New Jersey (license number 35SI00652600) 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 1962173872.
Healthcare Provider's Profile
| Full Name | Dr Lauren Rose Ellis |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 25 Sleepy Hollow Dr, Tabernacle, New Jersey |
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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: 1962173872
- Provider Enumeration Date: 09/22/2021
- Last Update Date: 02/24/2025
Medicare PECOS Information:
- PECOS PAC ID: 2860913316
- Enrollment ID: I20250312004100
Medical Identifiers
Medical identifiers for Dr Lauren Rose Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962173872 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 35SI00652600 (New Jersey) | 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 Lauren Rose Ellis allows following entities to bill medicare on her behalf.
| Entity Name | New Jersey Behavioral Health Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538744297
PECOS PAC ID: 4284001025
Enrollment ID: O20221108000033 |
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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 Lauren Rose 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 |
|---|
Dr Lauren Rose Ellis, PSYD
740 Marne Hwy,
Moorestown, NJ 08057-3126
Ph: (856) 553-0769 | Dr Lauren Rose Ellis, PSYD
25 Sleepy Hollow Dr,
Tabernacle, NJ 08088-8506
Ph: (718) 873-4908 |
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