Active NPI 1629530225 Individual Practitioner Female Practitioner

Dr. Colette Mark Ellis , MD

General Practice • Fairborn, OH

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Colette Ellis, MD is a registered healthcare professional specializing in General Practice in Fairborn, OH. Official NPI practice address is registered at 1059 BAYWOOD DR.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, removal of skin and tissue, 20.0 sq cm or less, removal of muscle and/or tissue, 20.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1059 Baywood Dr

Fairborn, OH 453242647

Telephone 7133390341

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Fairborn, OH

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 28.1 Yrs

Regional Practice Density

1 Specialists

Practicing in Fairborn, OH (336 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

63.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	174	63	$177.06	$72.54
11042 Removal of skin and tissue, 20.0 sq cm or less	78	27	$340.56	$110.57
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	63	34	$94.72	$38.54
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	58	16	$582.36	$222.86
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	51	27	$177.06	$72.54
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	45	27	$253.58	$103.93
11042 Removal of skin and tissue, 20.0 sq cm or less	31	15	$340.56	$57.52
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	18	18	$189.48	$78.77
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	16	14	$253.58	$103.93
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	16	14	$94.72	$38.54
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	16	16	$189.48	$78.76
99342 Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes	15	15	$180.36	$76.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	125	32	$600.90	$214.43
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	120	62	$164.76	$67.13
11042 Removal of skin and tissue, 20.0 sq cm or less	92	35	$339.66	$101.67
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	51	34	$215.06	$88.76
11042 Removal of skin and tissue, 20.0 sq cm or less	49	27	$339.66	$52.86
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	36	15	$600.90	$142.99
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	26	21	$164.76	$67.19
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	21	21	$211.56	$86.67
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	17	16	$215.06	$88.80
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	14	14	$103.86	$42.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	1,159	254	$93.00	$43.15
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	432	161	$169.81	$67.61
11042 Removal of skin and tissue, 20.0 sq cm or less	381	126	$206.23	$123.18
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	171	60	$93.00	$43.14
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	145	63	$329.05	$227.14
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	135	135	$189.33	$87.95
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	94	56	$169.55	$68.03
97597 Removal of tissue from wound, 20.0 sq cm or less	68	36	$150.00	$99.47
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	67	19	$62.79	$40.83
11042 Removal of skin and tissue, 20.0 sq cm or less	56	41	$222.45	$52.34
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	53	53	$191.13	$88.16
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	53	15	$132.03	$67.17
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	31	20	$200.51	$89.45
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	27	15	$389.16	$146.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	92	53	$200.00	$119.13
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	92	50	$93.00	$44.15
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	87	65	$170.00	$69.25
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	36	26	$300.00	$230.27
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	25	25	$189.00	$90.08
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	13	11	$170.00	$68.89

Medical Specialties & State Licenses

CMS Verified: 2022-07-27

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License TX S8030

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Surgery

NUCC Taxonomy Code: 208600000X

State License TX S8030

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

📍

Updated Practice Location July 27, 2022

Registered at 1059 BAYWOOD DR, FAIRBORN, OH 453242647 (Tel: 7133390341)

📍

Updated Business Mailing Address July 27, 2022

Registered at 1059 BAYWOOD DR, FAIRBORN, OH 453242647 (Tel: 7133390341)

📍

Updated Practice Location November 16, 2020

Registered at 2175 TUCKER ST APT 1318, DALLAS, TX 752144172 (Tel: 7133390341)

📍

Updated Business Mailing Address November 16, 2020

Registered at 2175 TUCKER ST APT 1318, DALLAS, TX 752144172 (Tel: 7133390341)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2020

Surgery (License #S8030 in TX)

✅

NPI Profile Active April 02, 2019

NPI status registered as active in NPPES database

📍

Updated Practice Location April 02, 2019

Registered at 3500 GASTON AVE, DALLAS, TX 752462017 (Tel: 2148202361)

📍

Updated Business Mailing Address April 02, 2019

Registered at 512 JEFFERSON ST, BRYAN, TX 778011436 (Tel: 7133390341)

👤

Provider Name / Credentials Updated April 02, 2019

Recorded as COLETTE ELLIS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 02, 2019

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration April 02, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629530225

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 02, 2019

Last Update: July 27, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1059 Baywood Dr

Fairborn, OH 453242647

Phone: 7133390341

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.