Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ellis Benjamin Gardner, MDFAAP

Individual provider Internal Medicine Physician · NPI 1932130630

Dr. Ellis Benjamin Gardner, MDFAAP is a Pediatric Medicine in Canaan, New Hampshire. Qualified in 1996, 30 years ago. Practices with Mascoma Community Healthcare Inc, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut and New Hampshire.

Years since qualifying
30
Licensed in
CT, NH
In the registry since
2006
Specialties on file
3

Practice location Address checks out

18 Roberts Rd
Canaan, NH 03741-7644
Phone: (603) 934-1464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 43 Caleb Dyer Ln, Enfield, NH 03748-3551 — (802) 673-5340

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 10330 (NH)
Pediatrics Physician Taxonomy 208000000X · Licence 10330 (NH)
Pediatrics Physician Taxonomy 208000000X · Licence 037734 (CT)

Record details

NPI number1932130630
Entity typeIndividual (Type 1)
GenderMale
Credentials MDFAAP
Sole proprietorNo
NPI enumeratedJuly 5, 2006
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Mascoma Community Healthcare Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare