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

Dr. Ellis Enabosi, MD

Individual provider General Practice Physician · NPI 1669866158

Dr. Ellis Enabosi, MD is a General Surgery in Staten Island, New York. Qualified in 2012, 14 years ago. Practices with Peyman Younesi MD PLLC, a 104-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

455 Jersey St
Staten Island, NY 10301-2976
Phone: (187) 524-5611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 460 N Maple Ave, East Orange, NJ 07017-4619 — (973) 280-9600
  • 2015 Grand Concourse, Bronx, NY 10453-4303 — (718) 299-7295

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 291470 (NY)
General Practice Physician Taxonomy 208D00000X · Licence 291470 (NY)

Record details

NPI number1669866158
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2015
Last updated in NPPESJanuary 8, 2021
Certification dateJanuary 8, 2021

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Peyman Younesi Md Pllc — 104 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Staten Island