MR. EUGENE ELLIS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1740311513

MR. EUGENE ELLIS (CRNA) is a healthcare provider. based in San francisco, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 3473 (CA). The NPI Number for MR. EUGENE ELLIS (CRNA) is 1740311513

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
MR. EUGENE ELLIS (CRNA)
NPI
1740311513
Phone
(415) 867-0177
Address
1385 HOLLOWAY AVE
Enumeration Date
7 March 2007
Last Update Date
29 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512627633
Graduation Year
2006 (20 years ago)
PAC ID
8426155862
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20250814003297
Address ID
MN554071321MI2925XAVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

2,470 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

Provider Addresses for MR. EUGENE ELLIS (CRNA)

  • 1385 HOLLOWAY AVE

    SAN FRANCISCO, CA 941322664

    Phone: (415) 867-0177

    Fax: (415) 867-0177

    Type: Mailing

  • 5801 NORTH CANYON RD

    SUITE 230

    SAN RAMON, CA 945835440

    Phone: (925) 275-9910

    Fax: (925) 275-9823

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-08-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070521000247ICertified Registered Nurse Anesthetist (Crna)CATBD
I20250814003297ICertified Registered Nurse Anesthetist (Crna)MNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94132)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587573613View full group profile

Reviews

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Frequently asked questions

What federal number belongs to MR. EUGENE ELLIS (CRNA)?
The federal identifier for MR. EUGENE ELLIS (CRNA) is NPI 1740311513.
Is MR. EUGENE ELLIS (CRNA) active in the national directory?
MR. EUGENE ELLIS (CRNA)'s public NPI profile is in an active state.
What does MR. EUGENE ELLIS (CRNA) treat or focus on?
Patients typically see MR. EUGENE ELLIS (CRNA) under the specialty Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for MR. EUGENE ELLIS (CRNA)?
We surface San Francisco, California for MR. EUGENE ELLIS (CRNA) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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