Individual provider Active NPI

Elizabeth Ann Loverso, PA-C

  • Physician Assistant
  • Cathedral City, CA
National Provider Identifier
1215114426
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61570 Issued in CA
Practice address
31755 Date Palm Dr
Cathedral City, CA 92234-3101
Phone
(760) 770-3399
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 001881 IA
Physician Assistant 363A00000X PA61570 CA Primary
Surgical Physician Assistant 363AS0400X 10001974A IN
Podiatrist 213E00000X 00610 IA
Physician Assistant 363A00000X 0010-08736 NC

Addresses

Primary practice location

31755 Date Palm Dr
Cathedral City, CA 92234-3101

Mailing address

1327 Via Palmera
Cathedral City, CA 92234-4394
Phone (812) 470-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240301002291 CA Practitioner - Physician Assistant 2961572714 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00610IAMDPodiatrist
PA61570CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Jan 16, 2024 Accepting new patients
County of Riverside CurrentSince Jan 16, 2024 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • Direct secure messaging: eloverso1023977@direct.llu.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1215114426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 VIA PALMERA",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922344394",
            "telephone_number": "812-470-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31755 DATE PALM DR",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343101",
            "telephone_number": "760-770-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVERSO",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "001881",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61570",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10001974A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00610",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08736",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

Verify at the official NPI Registry.