Marc Andrew Ellsworth, MD
NPI 1609171115ActiveIndividual· Pediatrics, Neonatal-Perinatal Medicine· Gilbert, AZ
Pediatrics, Neonatal-Perinatal Medicine (MD) in Gilbert, Arizona, licensed in AZ and MN, with an NPI issued in January 2011. Enrolled in Medicare as practitioner - other (physician).
Overview
| NPI | 1609171115 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Jan 13, 2011 |
| Last updated in NPPES | Dec 9, 2020 |
| Certified by provider | Dec 9, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics, Neonatal-Perinatal Medicine Primary | 2080N0001X | 51592 | AZ |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
| Pediatrics | 208000000X | 54096 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Other (Physician) (AZ) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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