ELLEN CANNON – Physician Assistant, NPI 1083169890
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,691 PHYSICIAN ASSISTANT in PA
Provider Addresses for ELLEN CANNON
160 E Erie Ave
Philadelphia, PA 191341011
Phone: (610) 209-6383
Type: Location
1023, Marlin Drive, Sconnelltown, East Bradford Township, Chester County, Pennsylvania, 19382, United States
WEST CHESTER, PA 193822360
Phone:
Type: Mailing
1610 CHRISTIAN ST APT 2
PHILADELPHIA, PA 191462066
Phone:
Type: Mailing
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 191044319
Phone: (610) 209-6383
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $90.
Total Amount is formed as General ($90) + Research ($0) + Ownership ($0) = $90.
Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Inari Medical, Inc. ($90).
Total Amount
$90
General + Research + Ownership
Payments
1
Total payment records
General Amount
$90
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $90 |
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: 2024-04-04
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 |
|---|---|---|---|---|
| I20240404003755 | I | Physician Assistant | CO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 19134)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MA | |
| Diagnostic Radiology | MO | |
| Interventional Radiology | WA | |
| Interventional Radiology, Diagnostic Radiology | TX | |
| Physician Assistant | IL | |
| Physician Assistant | PA | |
| Physician Assistant | CO |
Reviews
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