Provider Demographics
NPI:1942354246
Name:ELLIS, STEVEN FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FRANK
Last Name:ELLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5370 COLLEGE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1891
Mailing Address - Country:US
Mailing Address - Phone:913-599-4800
Mailing Address - Fax:913-599-2992
Practice Address - Street 1:5370 COLLEGE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1891
Practice Address - Country:US
Practice Address - Phone:913-599-4800
Practice Address - Fax:913-599-2992
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD110162207YX0007X
KS04-26174207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100189220AMedicaid
MO22918011OtherBCBS OF KC
KS1000267OtherUNITEDHEALTH CARE
KS100611OtherBCBS OF KS
KS1000267OtherUNITEDHEALTH CARE
KSE529210Medicare ID - Type Unspecified
KS100611Medicare ID - Type Unspecified
G24944Medicare UPIN
KS100611OtherBCBS OF KS