DR. ROBERT WILLIAM III ELLIS (MD) – Child & Adolescent Psychiatry Physician, NPI 1124006549

DR. ROBERT WILLIAM III ELLIS (MD) is a healthcare provider. based in Howell, Michigan. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 4301097679 (MI). The NPI Number for DR. ROBERT WILLIAM III ELLIS (MD) is 1124006549

Main info

Male
Sole Proprietor
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROBERT WILLIAM III ELLIS (MD)
NPI
1124006549
Phone
(517) 545-1010
Address
204 W GRAND RIVER AVE
Enumeration Date
5 January 2006
Last Update Date
9 June 2012

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5175455944
Graduation Year
1985 (41 years ago)
PAC ID
0143404087
Group Practice PAC ID
8527972223
Professional Enrollment ID
I20110418000559
Address ID
MI488432478HO2020XAVEX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,216 PSYCHIATRY in MI

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Provider Addresses for DR. ROBERT WILLIAM III ELLIS (MD)

  • 204, West Grand River Avenue, Howell, Livingston County, Michigan, 48843, United States

    SUITE 260

    HOWELL, MI 488432299

    Phone: (517) 545-1010

    Fax: (517) 545-1025

    Mailing address matches the actual address.

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: 2011-04-18

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
I20110418000559IPsychiatryMITBD

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 48843)

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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: 8527972223View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
Nurse PractitionerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Can I verify DR. ROBERT WILLIAM III ELLIS (MD) with an NPI only?
You can start verification with NPI 1124006549 for DR. ROBERT WILLIAM III ELLIS (MD), then check state licensing separately.
Does the file indicate DR. ROBERT WILLIAM III ELLIS (MD) is practicing under active NPI?
Directory data currently reports DR. ROBERT WILLIAM III ELLIS (MD) as active.
What healthcare role does DR. ROBERT WILLIAM III ELLIS (MD) hold?
Scheduling teams often label DR. ROBERT WILLIAM III ELLIS (MD) under Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. ROBERT WILLIAM III ELLIS (MD) on a map?
Expect Howell, Michigan as a primary anchor for DR. ROBERT WILLIAM III ELLIS (MD) unless the record lists multiple sites.
Is the information about DR. ROBERT WILLIAM III ELLIS (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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