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

Ethan R Ellis, MD

Individual provider Clinical Cardiac Electrophysiology Physician · NPI 1316110208

Ethan R Ellis, MD is a Cardiac Electrophysiology in Fort Collins, Colorado. Graduated from University of Rochester School of Medicine and Dentistry in 2006, 20 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado, Massachusetts and Nebraska.

Years since qualifying
20
Trained at
University of Rochester School of Medicine and Dentistry
Licensed in
CO, MA, NE
In the registry since
2008
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2121 E Harmony Rd Ste 100
Fort Collins, CO 80528-3400
Phone: (970) 221-1000
Show map & directions

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

Specialties & licences

Clinical Cardiac Electrophysiology Physician (primary) Taxonomy 207RC0001X · Licence DR.0053902 (CO)
Clinical Cardiac Electrophysiology Physician Taxonomy 207RC0001X · Licence 27958 (NE)
Internal Medicine Physician Taxonomy 207R00000X · Licence 235720 (MA)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence DR.0053902 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence DR.0053902 (CO)

Record details

NPI number1316110208
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2008
Last updated in NPPESMarch 28, 2016
Mailing address2121 E Harmony Rd, Ste 100, Fort Collins, CO 80528-3400

Medicare enrollment

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

Medicare specialtyCARDIAC ELECTROPHYSIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolUNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduated 2006 (20 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations16 on file with Medicare