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

Individual provider Vascular Surgery Physician · NPI 1073538823

Dr. Jonathan J Ellichman, MD is a Cardiac Surgery in Memphis, Tennessee. Qualified in 1999, 27 years ago. Practices with Southern Cardiovascular PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Mississippi and Tennessee.

Years since qualifying
27
Licensed in
MS, TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6401 Poplar Ave Ste 410
Memphis, TN 38119-4808
Phone: (901) 259-2718
Fax: (901) 259-1123
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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 18972 (MS)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence 39618 (TN)

Record details

NPI number1073538823
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 13, 2006
Last updated in NPPESMarch 8, 2016

Medicare enrollment

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

Medicare specialtyCARDIAC SURGERY
Also practisesTHORACIC SURGERY, VASCULAR SURGERY
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Southern Cardiovascular Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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