Elisa Nicole Kershaw, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C5-0001099 Issued in DE

Practice address

701 N Clayton St
Wilmington, DE 19805-3165

Phone

(302) 421-4100

NPI assigned

Oct 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• 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

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

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Psychiatry Physician
  • Chester, PA
  • NPI 1700231297
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1124570171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LAWRENCE RD STE 700",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083301",
            "telephone_number": "484-470-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053165",
            "telephone_number": "302-421-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW",
        "first_name": "ELISA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2020-11-30",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C5-0001099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Keough
• Abigail Kerchner
• Ryan Kerin
• Dynesha Kerkula, RN
• Janine Kerrigan
• Michelle K Kery, LPCMH
• Rachael Kery, LPCMH, NCC
• Michelle Hummel Kerzner, OTR
• Kenneth A Kessel, LCSW
• Maureen Victoria Kessler, CCC-SLP

• Surgical Physician Assistant in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Surgical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.