TEYLOR N ELLIS (PA-C) – Physician Assistant, NPI 1699402693
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for TEYLOR N ELLIS (PA-C)
401 N SENATE AVE UNIT 419
INDIANAPOLIS, IN 462041286
Phone: (317) 752-8191
Type: Mailing
5718 CRAWFORDSVILLE RD
INDIANAPOLIS, IN 462243704
Phone: (317) 240-5001
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $74.
Total Amount is formed as General ($74) + Research ($0) + Ownership ($0) = $74.
Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Gilead Sciences, Inc. ($34).
Total Amount
$74
General + Research + Ownership
Payments
3
Total payment records
General Amount
$74
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Gilead Sciences, Inc. | $34 |
| Novo Nordisk Inc | $21 |
| PFIZER INC. | $20 |
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: 2022-10-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221021000610 | I | Physician Assistant | IN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 13 | 13 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 12 | 12 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 11 | 11 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 11 | 11 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 46204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | NE | |
| Family Practice | IN | |
| Family Practice | IN | |
| Physician Assistant | IN | |
| Clinical Psychologist | IN | |
| Physician Assistant | IN | |
| Clinical Social Worker | IN | |
| O P T O M E T R Y | IN | |
| - | IN | |
| Physician Assistant | IN |
Reviews
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