Doctor profile · Federal record
Dr. Ryan Ellsworth, DPM
Foot Surgery Podiatrist (CMS: Podiatry) · Podiatrist · Podiatrist · Podiatrist · Podiatrist · Primary Podiatric Medicine Podiatrist · Radiology Podiatrist · Sports Medicine Podiatrist · Foot & Ankle Surgery Podiatrist · Atlanta, GA
- NPI 1104130574
- MIPS 75.0 / 100 · 2023
- 16 yrs in practice
- Licensed in 5 states
- Male
- Solo practice
- No sanctions
Practice & contact
Operates at 10 locations across 2 states.
- Primary practice
-
505 Fairburn RD Sw Ste 100
Atlanta, GA 303312012
(404) 618-6077
fax (801) 253-6888 - Mailing address
-
9980 S 300 W Ste 300
Sandy, UT 840703654
Utah — 8 locations
- Additional location
-
12523 S Creek Meadow RD Ste 105
Riverton, UT 840657299
(801) 253-6886 - Additional location
-
2019 E Riverside Dr Ste A101
St George, UT 847908147
(801) 253-6886 - Additional location
-
227 N Westwood Blvd
Price, UT 845015500
(801) 253-6886 - Additional location
-
3130 S Highland Dr Ste B4
Salt Lake City, UT 841063095
(801) 253-6886 - Additional location
-
3355 N University Ave Ste 175
Provo, UT 846046620
(801) 253-6886 - Additional location
-
4019 W 12600 S, Suite 120
Riverton, UT 84096
(801) 253-6886 - Additional location
-
770 S Highway 99
Fillmore, UT 846315033
(801) 253-6886 - Additional location
-
95 White Sage Ave Ste C
Delta, UT 846245555
(801) 253-6886
Florida — 1 location
- Additional location
-
12780 Race Track RD Ste 417
Tampa, FL 336261395
(813) 535-7707
Credentials & registration
- NPI registered
- July 2010 — 16 yrs on file
- Profile last updated
- June 17, 2024
- Year of graduation
- 2010 — 16 yrs since
- Specialty taxonomy
- 213ES0131X — NUCC code
- State licenses (5)
- Utah #8400193-0501 · Nevada #2109 · California #E5797 · Florida #PO4406 · Georgia #POD001473
- Medicaid
- UT #1003111
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1104130574. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
11,235
Distinct HCPCS
10
Medicare allowed
$11,449,755
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
Q4204 |
Xwrap, per square centimeter | 3,730 | 31 | $1,352 | |
Q4250 |
Amnioamp-mp, per square centimeter | 2,678 | 27 | $1,511 | |
Q4248 |
Dermacyte amniotic membrane allograft, per square centimeter | 1,665 | 25 | $1,008 | |
Q4259 |
Celera dual layer or celera dual membrane, per square centimeter | 470 | 11 | $981 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 361 | 118 | $86 | |
15271 |
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 279 | 35 | $142 | |
11042 |
Removal of skin and tissue, 20.0 sq cm or less | 250 | 40 | $68 | |
73630 |
X-ray of foot, minimum of 3 views | 224 | 119 | $32 | |
64455 |
Injection of anesthetic and/or steroid drug into foot nerve | 193 | 70 | $47 | |
15275 |
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 183 | 36 | $150 |
In context: peer comparison
Among 1 peers in Atlanta Foot Surgery Podiatrist, average services per provider: 468. This provider delivers 24× the peer median.Open Payments
Industry payments received
All-time total
$105
Transactions
5
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Abbvie INC. | 2 | $47.15 | |
| McKesson Medical-Surgical, INC. | 1 | $22.01 | |
| Medtronic, INC. | 1 | $18.39 | |
| Solventum Corporation | 1 | $17.10 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
21
Patients
0
Total drug cost
$320
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Gabapentin | Generic | 21 | 0 | $320 |
Frequently asked questions
What is Dr. Ryan Ellsworth's medical specialty?
Dr. Ryan Ellsworth practices Foot Surgery Podiatrist in Atlanta, GA.
Where does Dr. Ryan Ellsworth practice?
Dr. Ryan Ellsworth practices at 505 Fairburn RD Sw Ste 100, Atlanta, GA 303312012. Office phone: 4046186077.
What is Dr. Ryan Ellsworth's NPI?
Dr. Ryan Ellsworth's National Provider Identifier (NPI) is 1104130574, issued by NPPES.
Does Dr. Ryan Ellsworth accept Medicare assignment?
Dr. Ryan Ellsworth does not accept Medicare assignment for all services. Patients may be billed amounts beyond Medicare-allowed charges.
What procedures does Dr. Ryan Ellsworth commonly perform?
Top Medicare-reported procedures in 2023: Xwrap, per square centimeter (HCPCS Q4204); Amnioamp-mp, per square centimeter (HCPCS Q4250); Dermacyte amniotic membrane allograft, per square centimeter (HCPCS Q4248). Source: CMS Medicare Physician & Other Practitioners file.