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

Kathleen Dunlevy Ellis, PA-C

Individual provider Surgical Physician Assistant · NPI 1891570545

Kathleen Dunlevy Ellis, PA-C is a Physician Assistant in Mishawaka, Indiana. Qualified in 2023, 3 years ago. Practices with Saint Joseph Regional Medical Center Inc, a 141-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
3
Licensed in
IN
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

611 E Douglas Rd Ste 207
Mishawaka, IN 46545-1465
Phone: (574) 335-6850
Show map & directions

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

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 10004107A (IN)

Record details

NPI number1891570545
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 30, 2023
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Saint Joseph Regional Medical Center Inc — 141 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare