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Dr. Colette Mark Ellis , MD

General Practice • Fairborn, OH

Active NPI 1629530225 Individual Practitioner Female Practitioner
Practice location in NPPES

1059 Baywood Dr
Fairborn, OH 453242647

Call 7133390341 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1059 Baywood Dr

Fairborn, OH 453242647

Telephone 7133390341

Medicare-allowed amount

About $52,866 in 2023

The total amount Medicare approved for these services in 2023. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2023.

Paid by Medicare

About $42,198 in 2023

The part of the Medicare-allowed amount that Medicare itself paid in 2023, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2023.

Open Payments general payments, program year 2020

All general payments: $53.75 across 3 records.

By nature of payment

  • Food and Beverage: $53.75 across 3 records.

Reporting-company totals

  • Smith+Nephew, Inc.: $33.75 across 2 records.
  • ConvaTec Inc.: $20.00 across 1 record.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2020 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Ellis has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Ellis as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Fairborn and Ohio

Billing and prescribing volume is not a quality rating.

Medicare Part B

Comparisons use 2024 data. The latest CMS data for Dr. Ellis are from 2023.

1 active clinicians are listed under General Practice with a practice address in Fairborn, OH (281 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Medicare Physician & Other Practitioners (2023), CMS Open Payments (2020), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2020

Program year 2020 (payments made January 1 – December 31, 2020): fewer than 11 records totaling $53.75.

Manufacturer Payment Nature Product Type Amount ($)
ConvaTec Inc.
Food and Beverage
Cash or cash equivalent
AQUACEL AG General $20.00
Smith+Nephew, Inc.
Food and Beverage
In-kind items and services
RENASYS General $18.75
Smith+Nephew, Inc.
Food and Beverage
In-kind items and services
RENASYS General $15.00

Source: CMS Open Payments, program year 2020, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2023.

CMS Part B · Data Year 2023
Reporting Year:

CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2019–2022 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2020–2023; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more
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, 20 minutes or more
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
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
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
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
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

Source: CMS Part B by Provider and Service, 2023; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-07-27
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

License # reported to NPPES 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

License # reported to NPPES 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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - GENERAL PRACTICE

Medicare Enrollment ID

I20200915001233

Enrollment State Jurisdiction

TX

PECOS Control ID

1658609342

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

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 number reported to NPPES: TX S8030)

✅
NPI Profile Active April 02, 2019

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) April 02, 2019

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

📍
Business Mailing Address (Initial Record) April 02, 2019

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

👤
Provider Name / Credentials (Initial Record) 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.

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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

Mailing Address

1059 Baywood Dr

Fairborn, OH 453242647

Phone: 7133390341

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.