DONALD ELLIS (M.D.) – Family Medicine Physician, NPI 1700893377

DONALD ELLIS (M.D.) is a healthcare provider. based in Tawas city, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 4301070492 (MI). The NPI Number for DONALD ELLIS (M.D.) is 1700893377

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DONALD ELLIS (M.D.)
NPI
1700893377
Phone
(989) 739-1441
Address
PO BOX 779
Enumeration Date
3 August 2006
Last Update Date
23 February 2023

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
9893624626
Graduation Year
1997 (29 years ago)
PAC ID
9133278245
Group Practice PAC ID
9638070766
Professional Enrollment ID
I20100605000220
Address ID
MI487638211TA325XXMXXX324

Contacts

Secure Messaging
donellis@smomsjhs.allscriptsdirect.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

4,418 FAMILY PRACTICE in MI

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Provider Addresses for DONALD ELLIS (M.D.)

  • PO BOX 779

    TAWAS CITY, MI 487640779

    Phone: (989) 739-1441

    Fax: (989) 739-6093

    Type: Mailing

  • Huron Road, Oscoda, Oscoda Township, Iosco County, Michigan, United States

    OSCODA, MI 487509710

    Phone: (989) 739-1441

    Fax: (989) 739-6093

    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: 2010-06-05

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
I20100605000220IFamily PracticeMITBD

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 48764)

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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: 9638070766View full group profile
NameSpecialtyState
-MI
O T O L A R Y N G O L O G YMI
Internal MedicineMI
-MI
O B S T E T R I C S/ G Y N E C O L O G YMI
Nurse PractitionerMI
Medical OncologyIA
Physician AssistantMI
General SurgeryAZ
-MI

Reviews

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Frequently asked questions

What unique ID ties claims to DONALD ELLIS (M.D.)?
NPI 1700893377 is assigned to DONALD ELLIS (M.D.) under the national enumeration system.
Is DONALD ELLIS (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DONALD ELLIS (M.D.) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for DONALD ELLIS (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for DONALD ELLIS (M.D.)?
We surface Tawas City, Michigan for DONALD ELLIS (M.D.) based on available NPPES addresses.
What if Tawas City, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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