DR. DUSTIN CLAY ELLIS (M.D.) – Family Medicine Physician, NPI 1962658989
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
2,862 FAMILY PRACTICE in IN
Provider Addresses for DR. DUSTIN CLAY ELLIS (M.D.)
2229 Mary Sherman Dr
Sullivan, IN 478827633
Phone: (812) 268-3318
Fax: (812) 268-4017
Type: Location
230, Flanders Pond Road, Sullivan, Hancock County, Maine, 04664, United States
2229 MARY SHERMAN DRIVE
SULLIVAN, IN 478820230
Phone: (812) 268-3318
Fax: (812) 268-4017
Type: Mailing
North Hospital Boulevard, Benefiel Corner, Sullivan County, Indiana, 47882, United States
SULLIVAN, IN 478827654
Phone: (812) 268-3318
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: 2009-04-06
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 |
|---|---|---|---|---|
| I20090406000246 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 496 | 270 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 147 | 126 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 112 | 18 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 61 | 33 | $0 |
| 93018 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician | 29 | 29 | $0 |
Insurance plans in this area (ZIP 47882)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Mental Health Counselor | IN | |
| Family Practice | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Psychiatry, Internal Medicine, Neuropsychiatry | GA | |
| Family Practice | ND | |
| Pain Management | OH |
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