Erik G Ellsworth

MD | Pediatric Cardiology | Male

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Complete Profile:

Erik G Ellsworth basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Cardiology
Provider Name :	Erik G Ellsworth
Credential :	MD
Gender :	Male

Business Address:

Erik G Ellsworth address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	1501 N Gilbert Rd Ste 203 Gilbert, AZ, 85234-2394 United States
Phone Number :	602-933-3366
Fax Number :	602-933-4264

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1306826896
NPI Entity Type :	Individual
First Enrolment Date :	19 Jan, 2006
Last Updated On :	18 Sep, 2018

Medicare Participation:

Erik G Ellsworth participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	6103893813
Medicare Enrollment ID :	I20090406000533
Primary Specialty :	Cardiac Surgery
Medical School :	Mayo Medical School
Graduation Year :	2003
Accepts Medicare?	Yes. Erik G Ellsworth accepts medicare insurance.

Group Practice Association:

Erik G Ellsworth is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Erik G Ellsworth is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Phoenix Children's Hospital	0446278584	278	1919 E Thomas Rd Phoenix, AZ - 850167710 Ph: 6029331000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Erik G Ellsworth are as mentioned. Primary taxonomy code for Erik G Ellsworth, MD is 2080P0202X (Pediatrics Pediatric Cardiology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0202X	Pediatrics Pediatric Cardiology	Yes	41569	AZ

Legacy Identifiers:

Other legacy medical identifiers of Erik G Ellsworth such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
404994	MEDICAID	AZ

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	3200 E Camelback Rd Ste 250 Phoenix, AZ, 85018-2327 United States
Phone Number :	602-933-1815

Business Location:

Patients can refer following map for directions to Erik G Ellsworth practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.