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

Dr. Shane Thomas Ellis, MD

Individual provider Internal Medicine Physician · NPI 1366701153

Dr. Shane Thomas Ellis, MD is an Internal Medicine in Minneapolis, Minnesota. Graduated from University of Pittsburgh School of Medicine in 2012, 14 years ago. Practices with Allina Health System, a 3,867-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
14
Trained at
University of Pittsburgh School of Medicine
Licensed in
MN
In the registry since
2012
Specialties on file
3
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

2925 Chicago Ave
Minneapolis, MN 55407
Phone: (612) 863-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2925 Chicago Ave, Minneapolis, MN 55407 — (612) 863-4000

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 57547 (MN)
General Practice Physician Taxonomy 208D00000X · Licence 57547 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366701153
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 14, 2012
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021
Mailing address2925 Chicago Ave, Minneapolis, MN 55407-1321

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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