RONALD K ELLSWORTH (MD) – Family Medicine Physician, NPI 1245556141

RONALD K ELLSWORTH (MD) is a healthcare provider. based in Cascade, Idaho. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. M-11978 (ID). The NPI Number for RONALD K ELLSWORTH (MD) is 1245556141

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
RONALD K ELLSWORTH (MD)
NPI
1245556141
Phone
(208) 382-4242
Address
402 LAKE CASCADE PKWY
Enumeration Date
16 April 2010
Last Update Date
13 February 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Secondary Phone
2083824285
Graduation Year
2010 (16 years ago)
PAC ID
3971778358
Group Practice PAC ID
6103739719
Professional Enrollment ID
I20130723000595
Address ID
ID836117702CA402XXPKWY400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

971 FAMILY PRACTICE in ID

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Provider Addresses for RONALD K ELLSWORTH (MD)

  • Cascade Medical Center, 402, Lake Cascade Parkway, Cascade, Valley County, Idaho, 83611, United States

    CASCADE, ID 836117702

    Phone: (208) 382-4242

    Fax: (208) 382-5081

    Type: Location

  • West Branch Trout Creek Spring, Hunters Lane, Strafford, Tredyffrin Township, Chester County, Pennsylvania, 19333, United States

    CASCADE, ID 836111330

    Phone: (208) 382-4242

    Fax: (208) 382-5081

    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: 2013-07-23

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
I20130723000595IFamily PracticeIDTBD

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 83611)

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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: 6103739719View full group profile
NameSpecialtyState
Clinical Social WorkerID
-ID
Emergency MedicineID
Physician AssistantID
Nurse PractitionerID
Physician AssistantID
Physician AssistantID
Family PracticeID
Physician AssistantID
Nurse PractitionerID

Reviews

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Frequently asked questions

How do payers reference RONALD K ELLSWORTH (MD)?
For RONALD K ELLSWORTH (MD), use NPI 1245556141 as the unique 10-digit identifier.
Is there an active status for RONALD K ELLSWORTH (MD)?
For scheduling context, RONALD K ELLSWORTH (MD) is shown as active in the registry.
What clinical focus is listed for RONALD K ELLSWORTH (MD)?
At a glance, RONALD K ELLSWORTH (MD) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is RONALD K ELLSWORTH (MD) located near Cascade?
RONALD K ELLSWORTH (MD) currently maps to Cascade, Idaho in this extract.
When was this NPI issued?
Enumeration for RONALD K ELLSWORTH (MD) is noted as April 16, 2010 where the registry provides it.

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