Elizabeth Ann Ertle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PENDING Issued in NV

Practice address

330 S Casino Center Blvd
Las Vegas, NV 89101-6102

Phone

(702) 671-3900

NPI assigned

Dec 10, 2021

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

Other names 1

• Elizabeth Ann Kennelly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

88.26 of 100Reported as group

Quality

90.39

Improvement activities

40

Cost

78.5

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dr Shetty PLLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1336636521
  NPD

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728777600000",
    "number": "1245999820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CATHEDRAL ROCK DR STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280466",
            "telephone_number": "702-341-9000",
            "fax_number": "702-341-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S CASINO CENTER BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016102",
            "telephone_number": "702-671-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTLE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KENNELLY",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gift Erondu
• Jenelee A Erquiza
• Erra Interiors LLC
• Babak Ershaghi, DDS
• Tara Erson, DMD
• Oghenetejiro Erusiafe
• Lakisha Erves
• Belinda Ervin
• Deborah Ervin, MS EDUCATION
• James Ervin Jr.

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.