Individual provider Active NPI

Elizabeth Lindley Wadhwa

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1255697611
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
308923 Issued in LA
Practice address
550 16TH St FL 4
Box 0434
San Francisco, CA 94158-2545
Phone
(415) 476-3874
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 308923 LA Primary

Addresses

Primary practice location

550 16TH St FL 4
Box 0434
San Francisco, CA 94158-2545

Mailing address

1501 Kings Highway
Attn: Leisa Oglesby (RM. 1-201)
Shreveport, LA 71103-4228
Phone (318) 675-4881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180731002859 LA Practitioner - Pediatric Medicine 2769773241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
308923LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Pediatrics CurrentSince Jul 1, 2018 Accepting new patients

Locations

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

Interoperability endpoints

  • Direct secure messaging: ewadhwa772954@direct.ochsner.org

Organizations & group practices 1

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1255697611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HIGHWAY",
            "address_2": "ATTN: LEISA OGLESBY (RM. 1-201)",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-4881",
            "fax_number": "318-675-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 16TH ST FL 4",
            "address_2": "BOX 0434",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582545",
            "telephone_number": "415-476-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHWA",
        "first_name": "ELIZABETH",
        "middle_name": "LINDLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "308923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.