JOHN ELLIS JR. AGENS (MD) – Geriatric Medicine (Internal Medicine) Physician, NPI 1144287087

JOHN ELLIS JR. AGENS (MD) is a healthcare provider. based in Tallahassee, Florida. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold the professional credentials MD. They hold a License No. ME 87099 (FL). The NPI Number for JOHN ELLIS JR. AGENS (MD) is 1144287087

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
JOHN ELLIS JR. AGENS (MD)
NPI
1144287087
Phone
(850) 645-9350
Address
PO BOX 3064300
Enumeration Date
26 April 2006
Last Update Date
13 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8506441543
Graduation Year
1986 (40 years ago)
PAC ID
2668631763
Group Practice PAC ID
3971608993
Professional Enrollment ID
I20120308000814
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

Provider Addresses for JOHN ELLIS JR. AGENS (MD)

  • Bento Box, West Tennessee Street, Tallahassee, Leon County, Florida, 32304, United States

    1115 WEST CALL STREET, SUITE 1121-C

    TALLAHASSEE, FL 323064300

    Phone: (850) 645-9350

    Fax: (850) 645-0577

    Type: Mailing

  • 4449 MEANDERING WAY

    FSU SENIORHEALTH AT WOK

    TALLAHASSEE, FL 323085740

    Phone: (850) 644-1543

    Fax: (850) 645-0577

    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: 2012-03-08

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
I20120308000814IInternal MedicineFLTBD

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 32306)

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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: 3971608993View full group profile
NameSpecialtyState
P S Y C H I A T R YFL
Nurse PractitionerFL
Family Practice, Geriatric MedicineGA
Family PracticeFL
Nurse PractitionerFL
Family PracticeFL
-FL
Internal Medicine, Geriatric MedicineFL
Family PracticeFL
-FL

Reviews

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Frequently asked questions

Is there an official ID for JOHN ELLIS JR. AGENS (MD) in U.S. healthcare records?
The official identifier for JOHN ELLIS JR. AGENS (MD) is NPI 1144287087.
Is JOHN ELLIS JR. AGENS (MD) shown as active in public data?
Registry records indicate JOHN ELLIS JR. AGENS (MD) maintains an active NPI.
How would a patient describe JOHN ELLIS JR. AGENS (MD)'s focus?
For JOHN ELLIS JR. AGENS (MD), the primary taxonomy reads as Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where in Florida is JOHN ELLIS JR. AGENS (MD) registered?
Use Tallahassee, Florida as the headline location for JOHN ELLIS JR. AGENS (MD) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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