ELLIS LORENZO WEBSTER (MD) – Otolaryngology Physician, NPI 1629025903

ELLIS LORENZO WEBSTER (MD) is a healthcare provider. based in Miami lakes, Florida. specializing in OTOLARYNGOLOGY. They hold the professional credentials MD. They hold a License No. ME70645 (FL). The NPI Number for ELLIS LORENZO WEBSTER (MD) is 1629025903

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
ELLIS LORENZO WEBSTER (MD)
NPI
1629025903
Phone
(305) 558-3724
Address
15280 NW 79TH CT STE 200
Enumeration Date
30 May 2006
Last Update Date
5 September 2025

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5617368141
Graduation Year
1991 (35 years ago)
PAC ID
8426020017
Group Practice PAC ID
4587556923
Professional Enrollment ID
I20040813000574
Address ID
FL334373776BO10150RDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

732 OTOLARYNGOLOGY in FL

Provider Addresses for ELLIS LORENZO WEBSTER (MD)

  • 15280 NW 79TH CT STE 200

    MIAMI LAKES, FL 330165873

    Phone: (305) 558-3724

    Fax: (954) 536-6837

    Type: Mailing

  • 10150 HAGEN RANCH RD

    BOYNTON BEACH, FL 334373776

    Phone: (561) 736-8141

    Fax: (561) 736-5662

    Type: Location

  • 13005, Southern Boulevard, Palm Beach County, Florida, 33470, United States

    SUITE 131

    LOXAHATCHEE, FL 334709206

    Phone: (561) 793-5077

    Fax: (561) 784-8243

    Type: Mailing

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: 2004-08-13

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
I20040813000574IOtolaryngologyFLTBD

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 33016)

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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: 4587556923View full group profile
NameSpecialtyState
-FL
O T O L A R Y N G O L O G YFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL

Reviews

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Frequently asked questions

How do I look up ELLIS LORENZO WEBSTER (MD) by NPI?
Use NPI 1629025903 when you need to reference ELLIS LORENZO WEBSTER (MD) in forms, claims, or directories.
Is ELLIS LORENZO WEBSTER (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does ELLIS LORENZO WEBSTER (MD) treat or focus on?
Patients typically see ELLIS LORENZO WEBSTER (MD) under the specialty Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What location shows for ELLIS LORENZO WEBSTER (MD)?
We surface Miami Lakes, Florida for ELLIS LORENZO WEBSTER (MD) based on available NPPES addresses.
How can I contact ELLIS LORENZO WEBSTER (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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