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

Dr. Nicholas C. Ellefson, DO

Individual provider Family Medicine Physician · NPI 1639699200

Dr. Nicholas C. Ellefson, DO is a Hospitalist in Superior, Wisconsin. Graduated from West Virginia School of Osteopathic Medicine in 2012, 14 years ago. Practices with St Marys Hospital of Superior, a 97-clinician group and accepts Medicare assignment. Licensed in Minnesota, Wisconsin and West Virginia.

Years since qualifying
14
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
MN, WI, WV
In the registry since
2017
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

3500 Tower Ave
Superior, WI 54880-4491
Phone: (715) 817-7100
Fax: (715) 817-7039
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 71579-21 (WI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 66646 (MN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 3356 (WV)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639699200
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 23, 2017
Last updated in NPPESJune 19, 2020
Certification dateJune 19, 2020
Mailing address1702 University Dr S, Fargo, ND 58103-4940

Medicare enrollment

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

Medicare specialtyHOSPITALIST
Also practisesFAMILY PRACTICE
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2012 (14 years in practice)
Group practice St Marys Hospital Of Superior — 97 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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