COLETTE MARK ELLIS (MD) – General Practice Physician, NPI 1629530225
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for COLETTE MARK ELLIS (MD)
Jefferson Street, Bryan, Brazos County, Texas, 77801, United States
BRYAN, TX 778011436
Phone: (713) 339-0341
Type: Mailing
Baylor University Medical Center, 3500, Gaston Avenue, Old East Dallas, Dallas, TX, Dallas, Dallas County, Texas, 75246, United States
DALLAS, TX 752462017
Phone: (214) 820-2361
Type: Location
1059 BAYWOOD DR
FAIRBORN, OH 453242647
Phone: (713) 339-0341
Type: Mailing
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.
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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: 2020-09-15
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 |
|---|---|---|---|---|
| I20200915001233 | I | General Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 225 | 90 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 109 | 42 | $0 |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 79 | 48 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 61 | 41 | $0 |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 58 | 16 | $0 |
Insurance plans in this area (ZIP 77801)
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