Derek Ellis
NPI 1720771587 · Psychiatric/Mental Health Nurse Practitioner · Lakeland, FL
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Derek Ellis is a Psychiatric/Mental Health Nurse Practitioner provider in Lakeland, FL (NPI 1720771587).
Provider details
- NPI number
- 1720771587
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 11024640 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-05-30
- Last updated
- 2023-05-30
- Certified
- 2023-05-30
Frequently asked questions
- What is Derek Ellis's NPI number?
- Derek Ellis's National Provider Identifier (NPI) is 1720771587, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Derek Ellis's specialty?
- Derek Ellis is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Derek Ellis located?
- Derek Ellis's practice location on file with NPPES is 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543.
- What is Derek Ellis's phone number?
- The practice phone number listed in the NPPES registry for Derek Ellis is (863) 687-1100.
- Does Derek Ellis accept Medicare?
- Derek Ellis is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Derek Ellis's NPI active?
- Yes — Derek Ellis's NPI (1720771587) is active in the NPPES registry as of the last update on 2023-05-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.