Individual provider Active NPI

Elizabeth S. Stetzer, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1346532074
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003627 Issued in VA
Practice address
825 Fairfax Ave
Suite 310
Norfolk, VA 23507-1914
Phone
(757) 446-7900
Fax
(757) 446-7464
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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 0110003627 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Suite 310
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-7900

Other identifiers 7

IdentifierTypeStateIssuer
PAROtherVAMULTIPLAN
-010OtherVATRICARE/CHAMPUS
8101073MedicaidNC
PAROtherVACORVEL
10078674POtherVAOPTIMA HEALTH
1346532074MedicaidVA
PAROtherVAUSA MANAGED CARE

Other names 1

  • Elizabeth Snellings Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20110801000002 VA Practitioner - Physician Assistant 5092983460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2075 Glenn Mitchell Dr
Virginia Beach, VA 23456-0179

600 Gresham Dr
Norfolk, VA 23507-1904

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110003627VAMDPhysician Assistant

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1346532074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-7900",
            "fax_number": "757-446-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 310",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-7900",
            "fax_number": "757-446-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETZER",
        "first_name": "ELIZABETH",
        "middle_name": "S.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-010",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101073",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10078674P",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346532074",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SNELLINGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.