COREY JAMES ELLIS (MD) – Sports Medicine (Family Medicine) Physician, NPI 1376509323
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
341 SPORTS MEDICINE in OH
Provider Addresses for COREY JAMES ELLIS (MD)
3333 W Tech Rd
Miamisburg, OH 453420955
Phone: (937) 641-4000
Fax: (937) 641-4619
Type: Location
1 Childrens Plz
Dayton, OH 454041815
Phone: (937) 641-4000
Fax: (937) 641-4500
Type: Location
725 UNIVERSITY BLVD
DAYTON, OH 454350001
Phone: (937) 245-7100
Fax: (937) 245-7999
Type: Mailing
30, East Apple Street, South Park Historic District, Dayton, Montgomery County, Ohio, 45409, United States
SUITE 2200
DAYTON, OH 454092939
Phone: (937) 208-2091
Fax: (937) 208-6141
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: 2004-10-14
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 |
|---|---|---|---|---|
| I20041014001270 | I | Sports Medicine | OH | 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 | 26 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 26 | 23 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 45342)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| SPORTS MEDICINE | OH | 73630 | X-ray of foot, minimum of 3 views | 21 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hand Surgery, Orthopedic Surgery | OH | |
| Physician Assistant | OH | |
| - | OH | |
| Cardiovascular Disease (Cardiology) | OH | |
| - | OH | |
| Physician Assistant | OH | |
| Thoracic Surgery | PA | |
| Physician Assistant | OH | |
| Nurse Practitioner | OH | |
| Physician Assistant | OH |
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