ROBERT S ELLIS (MD) – Trauma Surgery Physician, NPI 1093864027

ROBERT S ELLIS (MD) is a healthcare provider. based in Dallas, Texas. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. M1656 (TX). The NPI Number for ROBERT S ELLIS (MD) is 1093864027

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT S ELLIS (MD)
NPI
1093864027
Phone
(903) 324-6450
Address
PO BOX 846098
Enumeration Date
9 January 2007
Last Update Date
8 March 2022

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9365397415
Graduation Year
1996 (30 years ago)
PAC ID
6204881725
Group Practice PAC ID
1850547365
Professional Enrollment ID
I20050908001107
Address ID
TX773042808CO504XXBLVD400

Contacts

Secure Messaging
CONROE.COCCR.TXA@CCDA.HCADIRECT.NET
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,646 GENERAL SURGERY in TX

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Provider Addresses for ROBERT S ELLIS (MD)

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 752846098

    Phone: (903) 324-6450

    Type: Mailing

  • 910, East Houston Street, Tyler, Smith County, Texas, 75702, United States

    STE 530

    TYLER, TX 757028369

    Phone: (903) 531-5560

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $211.

Total Amount is formed as General ($211) + Research ($0) + Ownership ($0) = $211.

Last reported payment date: 2024-10-10 • Largest payer in this snapshot: Ethicon US, LLC ($118).

Total Amount

$211

General + Research + Ownership

Payments

7

Total payment records

General Amount

$211

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-10

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2005-09-08

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
I20050908001107IGeneral SurgeryTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes3626$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2322$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes1311$0
99238Hospital discharge day management, 30 minutes or less1313$0
View full utilization report →

Insurance plans in this area (ZIP 75284)

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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: 1850547365View full group profile
NameSpecialtyState
Certified Nurse Midwife (Cnm)TX
-TX
O B S T E T R I C S/ G Y N E C O L O G YTX
-TX
-TX
O T O L A R Y N G O L O G YTX
General Surgery, Critical Care (Intensivists)ID
General Surgery, Vascular SurgeryTX
General SurgeryTX
-TX

Reviews

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Frequently asked questions

Does ROBERT S ELLIS (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ROBERT S ELLIS (MD) uses 1093864027.
Is ROBERT S ELLIS (MD) listed as active for patients and plans?
The listing shows ROBERT S ELLIS (MD) as active in the NPI system.
What healthcare role does ROBERT S ELLIS (MD) hold?
Scheduling teams often label ROBERT S ELLIS (MD) under Trauma Surgery Physician. Clinical services aligned with this taxonomy classification.
What area does ROBERT S ELLIS (MD) serve?
ROBERT S ELLIS (MD)'s listing highlights Dallas, Texas; more addresses can appear in NPPES.
Why does ROBERT S ELLIS (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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