STEPHANIE ELLIS (CRNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1992351209
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,469 NURSE PRACTITIONER in PA
Provider Addresses for STEPHANIE ELLIS (CRNP)
110 HIDDEN VALLEY RD
MC MURRAY, PA 153172685
Phone: (724) 941-4070
Type: Mailing
2929 E THOMAS RD
PHOENIX, AZ 850168034
Phone: (602) 470-5000
Type: Mailing
5102 W CAMPBELL AVE
PHOENIX, AZ 850311703
Phone: (602) 655-1000
Type: Location
640 Jefferson Ave
Washington, PA 153014119
Phone: (724) 222-6603
Type: Location
1051 Country Club Rd
Monongahela, PA 150631553
Phone: (724) 258-8014
Type: Location
110 Hidden Valley Rd
Mc Murray, PA 153172685
Phone: (724) 941-4070
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: 2020-10-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20191120000060 | I | Nurse Practitioner | PA | TBD |
| I20201023000796 | I | Nurse Practitioner | AZ | 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 15317)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | AZ | |
| - | AZ | |
| General Surgery, Critical Care (Intensivists) | MI | |
| General Surgery | IL | |
| General Surgery | AZ | |
| - | AZ | |
| Diagnostic Radiology | NC | |
| - | AZ | |
| - | AZ |
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