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

Mr. Jacob Ellis, PA-C

Individual provider Vascular Surgery Physician · NPI 1407730765

Mr. Jacob Ellis, PA-C is a Vascular Surgery Physician in Colorado Springs, Colorado. Practices as a sole proprietor. Licensed in Colorado.

Licensed in
CO
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7808 Ultra Dr
Colorado Springs, CO 80920-8058
Phone: (719) 209-5569
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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 1234 (CO)

Record details

NPI number1407730765
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 31, 2025
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025

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