DAVID M ELLISON (MD) – Internal Medicine Physician, NPI 1104867795

DAVID M ELLISON (MD) is a healthcare provider. based in West chester, Ohio. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. 35.082208 (OH). The NPI Number for DAVID M ELLISON (MD) is 1104867795

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
DAVID M ELLISON (MD)
NPI
1104867795
Phone
(937) 241-1830
Address
7908 CINCINNATI DAYTON RD
Enumeration Date
8 June 2006
Last Update Date
27 January 2015

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
5138879400
Graduation Year
2000 (26 years ago)
PAC ID
8224016266
Group Practice PAC ID
0042487456
Professional Enrollment ID
I20040707001578
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for DAVID M ELLISON (MD)

  • Cincinnati-Dayton Road, Olde West Chester, West Chester Township, Butler County, Ohio, 45069, United States

    SUITE J

    WEST CHESTER, OH 450696608

    Phone: (937) 241-1830

    Fax: (888) 418-2057

    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)

CMS reports 5 Open Payments records for all available years, with a total value of $127.

Total Amount is formed as General ($127) + Research ($0) + Ownership ($0) = $127.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: BeiGene USA, Inc. ($98).

Total Amount

$127

General + Research + Ownership

Payments

5

Total payment records

General Amount

$127

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
BeiGene USA, Inc.$98
ABBVIE INC.$30
View all Open Payments →|Open Payments Risk Radar →

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: 2004-07-07

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
I20040707001578IInternal MedicineOHTBD

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 45069)

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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: 0042487456View full group profile

Reviews

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Frequently asked questions

Is DAVID M ELLISON (MD) listed with a National Provider Identifier?
Yes — DAVID M ELLISON (MD) has NPI 1104867795 on file in the registry.
Is DAVID M ELLISON (MD) shown as active in public data?
Registry records indicate DAVID M ELLISON (MD) maintains an active NPI.
What kind of doctor is DAVID M ELLISON (MD)?
DAVID M ELLISON (MD) is associated with Internal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DAVID M ELLISON (MD) associated with West Chester?
Public fields place DAVID M ELLISON (MD) around West Chester, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DAVID M ELLISON (MD) is noted as June 8, 2006 where the registry provides it.

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