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

Individual provider Vascular Surgery Physician · NPI 1073538823

Dr. Jonathan J Ellichman, MD is a Cardiac Surgery in Memphis, Tennessee. Qualified in 1999, 27 years ago. Practices with Southern Cardiovascular PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Mississippi and Tennessee.

Years since qualifying
27
Licensed in
MS, TN
In the registry since
2006
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

6401 Poplar Ave Ste 410
Memphis, TN 38119-4808
Phone: (901) 259-2718
Fax: (901) 259-1123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 18972 (MS)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence 39618 (TN)

Record details

NPI number1073538823
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 13, 2006
Last updated in NPPESMarch 8, 2016
Mailing address1779 Kirby Pkwy # 1-511, Memphis, TN 38138-3666

Medicare enrollment

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

Medicare specialtyCARDIAC SURGERY
Also practisesTHORACIC SURGERY, VASCULAR SURGERY
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Southern Cardiovascular Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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