MR. DAVID GARTH SR. ELLERTSON (M.D.) – Vascular Surgery Physician, NPI 1912964495

MR. DAVID GARTH SR. ELLERTSON (M.D.) is a healthcare provider. based in Modesto, California. specializing in Vascular Surgery Physician. They hold the professional credentials M.D.. They hold a License No. G17987 (CA). The NPI Number for MR. DAVID GARTH SR. ELLERTSON (M.D.) is 1912964495

Main info

Male
Sole Proprietor
58 Years Of Experience
Accepts Medicare Assignment
Name
MR. DAVID GARTH SR. ELLERTSON (M.D.)
NPI
1912964495
Phone
(209) 524-8346
Address
4101 TULLY RD
Enumeration Date
27 April 2006
Last Update Date
12 February 2015

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Secondary Phone
2093425125
Graduation Year
1968 (58 years ago)
PAC ID
8325931454
Group Practice PAC ID
2365541653
Professional Enrollment ID
I20040203001131
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. DAVID GARTH SR. ELLERTSON (M.D.)

  • 4101, Tully Road, Modesto, Stanislaus County, California, 95356, United States

    SUITE 101

    MODESTO, CA 953568980

    Phone: (209) 524-8346

    Fax: (209) 524-7723

    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)

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: 2004-02-03

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040203001131IVascular SurgeryCATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes874134$0
29581Application of vein wound compression bandages on lower leg, ankle, and foot35564$0
93925Ultrasound of leg arteries or artery grafts3737$0
93970Ultrasound study of arm or leg veins with compression and maneuvers3737$0
99204New patient office or other outpatient visit, 45-59 minutes2525$0
View full utilization report →

Insurance plans in this area (ZIP 95356)

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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: 2365541653View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
-CA
O B S T E T R I C S/ G Y N E C O L O G YCA

Reviews

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Frequently asked questions

What federal number belongs to MR. DAVID GARTH SR. ELLERTSON (M.D.)?
The federal identifier for MR. DAVID GARTH SR. ELLERTSON (M.D.) is NPI 1912964495.
Is MR. DAVID GARTH SR. ELLERTSON (M.D.)'s NPI currently valid?
The extract we use shows MR. DAVID GARTH SR. ELLERTSON (M.D.) as active.
What does MR. DAVID GARTH SR. ELLERTSON (M.D.) treat or focus on?
Patients typically see MR. DAVID GARTH SR. ELLERTSON (M.D.) under the specialty Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Does MR. DAVID GARTH SR. ELLERTSON (M.D.) practice in California?
You will see Modesto, California on file for MR. DAVID GARTH SR. ELLERTSON (M.D.) alongside any extra practice locations.
What if Modesto, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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