MR. MARK D. ELLIS (N.P.) – Family Nurse Practitioner, NPI 1508868530
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for MR. MARK D. ELLIS (N.P.)
Space Center Boulevard, Houston, Harris County, Texas, 77058, United States
HOUSTON, TX 770593599
Phone: (832) 775-9800
Fax: (832) 775-9819
Type: Mailing
208 HALEY RD
JOHNSON CITY, TX 786364617
Phone: (830) 868-9500
Fax: (830) 868-4606
Type: Location
PO BOX 844658
DALLAS, TX 752844658
Phone: (254) 724-2111
Type: Mailing
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 $103.
Total Amount is formed as General ($103) + Research ($0) + Ownership ($0) = $103.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: Exact Sciences Corporation ($65).
Total Amount
$103
General + Research + Ownership
Payments
5
Total payment records
General Amount
$103
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exact Sciences Corporation | $65 |
| GlaxoSmithKline, LLC. | $38 |
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: 2012-01-10
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 |
|---|---|---|---|---|
| I20120110000755 | I | Nurse Practitioner | TX | 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 77059)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | TX | |
| - | TX | |
| Physician Assistant | TX | |
| Family Practice | TX | |
| Family Practice | TX | |
| Family Practice | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | MI | |
| Family Practice | TX |
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