DR. MARK BRIAN ELLIS (D.O.) – Family Medicine Physician, NPI 1083632244
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,754 FAMILY PRACTICE in AL
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Provider Addresses for DR. MARK BRIAN ELLIS (D.O.)
1018, Rucker Boulevard, Wooddale, Enterprise, Coffee County, Alabama, 36330, United States
STE A
ENTERPRISE, AL 363303675
Phone: (334) 347-4343
Fax: (334) 393-9611
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $33.
Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.
Last reported payment date: 2024-03-08 • Largest payer in this snapshot: Amgen Inc. ($17).
Total Amount
$33
General + Research + Ownership
Payments
2
Total payment records
General Amount
$33
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $17 |
| GlaxoSmithKline, LLC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040518000754 | I | Family Practice | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 325 | 165 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 191 | 109 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 122 | 27 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 119 | 65 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 78 | 42 | $0 |
Insurance plans in this area (ZIP 36330)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | AL | 81002 | Urinalysis, manual test | 61 | 33 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Family Practice, Preventive Medicine | AL | |
| - | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | AL | |
| General Surgery | IL | |
| Family Practice | AL |
Reviews
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