CLAY ELLENWOOD PA-C NPI 1588134456

NPI Information

NPI: 1588134456
Provider Name: CLAY ELLENWOOD, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
7232 JUSTIN WAY
MENTOR, OH
ZIP 44060
Phone: (440) 578-8200
Get Directions

Clay Ellenwood, PA-C is a medical physician assistant in Mentor, OH. Clay Ellenwood, PA-C NPI is 1588134456. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7232 JUSTIN WAY
MENTOR, OH
ZIP 44060-881
Phone: (440) 578-8200

The NPI 1588134456 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Psychiatric diagnostic evaluation with medical services (HCPCS:90792)

The enumeration date for this NPI number is 12/4/2018 and was last updated on 8/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601008913	MICHIGAN	No
2	363AM0700X	Physician Assistant	Medical	50.006802RX	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5601008913	OTHER	MICHIGAN	DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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