Elise Nicole Van Etten, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0004919 Issued in CO

Practice address

13123 E 16TH Ave # 323
Anschutz Medical Campus
Aurora, CO 80045-7106

Phone

(703) 328-2787

NPI assigned

Mar 3, 2017

Last updated

Oct 16, 2019By the provider in NPPES

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

• Elise Nicole Shellenberger Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eshellenberger96770@direct.childrenscolorado.org

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.

• University Physicians Incorporated

  dba CU Medicine

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1962461889

  Physician Assistant

  Medicare reassignment NPD (past)
• Children's Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• University Physicians Incorporated

  dba CU Medicine Maternal Fetal Medicine - Littleton

  • Maternal & Fetal Medicine Physician
  • Littleton, CO
  • NPI 1023476520
  NPD
• University Physicians, Incorporated

  dba CU Sports Medicine Colorado Center

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1275045049
  NPD

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1326588732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # 323",
            "address_2": "ANSCHUTZ MEDICAL CAMPUS",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "703-328-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # 323",
            "address_2": "ANSCHUTZ MEDICAL CAMPUS",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "703-328-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ETTEN",
        "first_name": "ELISE",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "0004919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "SHELLENBERGER",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Van Der Bosch, MD
• Ashleigh Van Deusen, MD
• Alison Van Diggelen, MSW
• Erin L Van Dok, OD
• Corinne Lynn Van Dyke, PA-C
• Stephanie Van Horn, PHD
• Johan Van Hove, HOVE
• Jessica Van Ingen
• Courtney Van Laare
• Jessica Van Laren, PHARMD

• Surgical Physician Assistant in Aurora, CO
• Providers in Aurora, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.