Elisabeth Marie Campbell, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3094 Issued in CT

Practice address

114 Woodland St
Deptartment of Surgery
Hartford, CT 06105-1208

Phone

(860) 714-5237

NPI assigned

Nov 5, 2010

Last updated

Jul 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecampbell17692@connecticutchildrens.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882

  Physician Assistant

  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Connecticut Children's Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hartford, CT
  • NPI 1578106951
  NPD (past)
• Plastic Surgery Trauma Associates, LLC

  • Plastic Surgery Physician
  • Boca Raton, FL
  • NPI 1538079868
  NPD (past)
• Samuel J. Margiotta, Jr, MD, PA

  • Surgery Physician
  • Loxahatchee, FL
  • NPI 1790866630
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1114228251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPTARTMENT OF SURGERY",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELISABETH",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105547",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alister Bruce Campbell, M.D.
• Bonnie Campbell, D.O.
• Brendan Thomas Campbell, MD
• Carol Campbell, ACNP
• Christine Campbell
• Falak Aaliyah Campbell, B.A.
• Kerry-Ann Campbell, LMSW
• Nicole Leslie Campbell, MSW, DSW, LCSW
• Robyn Noelle Campbell
• Makayla C Campelo, PA-C

• Surgical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.