Mireille F Ellis, PA in Alpharetta, GA - Medicare Dietitian, Registered

Mireille F Ellis, PA is a medicare enrolled "Dietitian, Registered" in Alpharetta, Georgia. Her current practice location is 2650 Holcomb Bridge Rd Ste 510, Alpharetta, Georgia. You can reach out to her office (for appointments etc.) via phone at (404) 255-4080.

Mireille F Ellis is licensed to practice in Georgia (license number 001471) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1154442200.

Contact Information

	Mireille F Ellis, PA
	2650 Holcomb Bridge Rd Ste 510, Alpharetta, GA 30022-5374
	(404) 255-4080
	Not Available

Provider's Profile

Full Name	Mireille F Ellis
Gender	Female
Speciality	Dietitian, Registered
Location	2650 Holcomb Bridge Rd Ste 510, Alpharetta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154442200
Provider Enumeration Date: 04/03/2007
Last Update Date: 04/19/2023

Medicare PECOS Information:

PECOS PAC ID: 9537491147
Enrollment ID: I20191031002606

Medical Identifiers

Medical identifiers for Mireille F Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154442200	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	6652 (Georgia)	Secondary
133V00000X	Dietitian, Registered	001471 (Georgia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mireille F Ellis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mireille F Ellis, PA 5835 Lenox Park Pl, Buford, GA 30518-7690 Ph: (602) 684-4682	Mireille F Ellis, PA 2650 Holcomb Bridge Rd Ste 510, Alpharetta, GA 30022-5374 Ph: (404) 255-4080

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Mireille F Ellis, PA - Medicare Dietitian, Registered in Alpharetta, GA