Elizabeth Disney
Individual provider Active NPI Obstetrics & Gynecology Physician · Plymouth, NH
NPI 1124412119 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1124412119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 21524 (NH)
- Practice address
- 16 Hospital Rd
Plymouth, NH 03264-1199 - Phone
- (603) 536-1104
- Fax
- (603) 536-7260
- NPI assigned
- Mar 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Speare Memorial Hospital
Practice addresses (Care Compare)
16 Hospital Rd
Plymouth, NH 03264-1126
178 Daniel Webster Hwy
Meredith, NH 03253-5664
Phone (603) 536-1120
Hospital & facility affiliations
- Speare Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191111000798 | VT | Practitioner - Obstetrics/Gynecology | 8921387754 | Reassigns benefits to 1 organization |
| I20211116001194 | NH | Practitioner - Obstetrics/Gynecology | 8921387754 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042.0014325 | VT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speare Memorial Hospital | Single Specialty | Current |
Accepting new patients |
| Speare Memorial Hospital | Single Specialty | Current | Accepting new patients |
| Northwestern Medical Center, Inc. | Single Specialty | Current | Accepting new patients |
| Northwestern Medical Center, Inc | Single Specialty | Current |
Accepting new patients |
| Speare Memorial Hospital | Single Specialty | Current |
Accepting new patients |
| Speare Memorial Hospital | Single Specialty | Current |
Accepting new patients |
| Northwestern Medical Center Inc | Single Specialty | Current |
Accepting new patients |
| Speare Memorial Hospital | Single Specialty | Current |
Accepting new patients |
| Speare Memorial Hospital | Single Specialty | Past | Accepting new patients |
Locations
178 Daniel Webster Hwy
Ste B
Meredith, NH 03253
16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229
3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554
133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | 042.0014325 | VT | |
| Obstetrics & Gynecology Physician | 207V00000X | 21524 | NH | Yes |
Addresses
Primary practice location
16 Hospital Rd
Plymouth, NH 03264-1199
Mailing address
16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 536-1120
Other practice location 1
133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-5911
Other practice location 2
500N Medical Dr
Salt Lake City, UT 84132-2209
Phone (801) 581-7647
Other providers in Plymouth, NH
- Joshua James Desclos
- Ian Detamore
- Kimberly Jean Di Salvo
- Vu V Dinh
- Cecilia Lynch Disney
- Ruth Alexander Doane
- Katrina Dopp
- Henry Daniel Dougherty
- Anne Maureen Doyle
- Jake Dreyfus
All providers in Plymouth, NH · Obstetrics & Gynecology Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.