Individual provider Active NPI

Elizabeth Jochem

  • Physician Assistant
  • Millbrae, CA
National Provider Identifier
1205424769
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59376 Issued in CA
Practice address
190 Broadway
Millbrae, CA 94030-2506
Phone
(505) 862-2109
NPI assigned
Jan 8, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59376 CA Primary

Addresses

Primary practice location

190 Broadway
Millbrae, CA 94030-2506

Mailing address

190 Broadway
Millbrae, CA 94030-2506
Phone (505) 862-2109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20240106000976 NM Practitioner - Physician Assistant 4385045863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113-1718
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA59376CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 29, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 29, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

8312 Kaseman Ct NE
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1205424769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302506",
            "telephone_number": "505-862-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302506",
            "telephone_number": "505-862-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOCHEM",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrae, CA

Sources for this page

Verify at the official NPI Registry.