Individual provider Active NPI

Elizabeth Kathryn Walterhouse, PA-S

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1356198741
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200001964 Issued in DC
Practice address
2041 Georgia Ave NW # 1-400
Washington, DC 20060-0002
Phone
(202) 865-1141
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA200001964 DC Primary

Addresses

Primary practice location

2041 Georgia Ave NW # 1-400
Washington, DC 20060-0002

Mailing address

2140 L St NW Apt 914
Washington, DC 20037-1531
Phone (810) 919-9113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240827003314 DC Practitioner - Physician Assistant 0345789939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA200001964DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC CurrentSince Sep 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients
Cep America LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

110 Irving St NW
#C2149
Washington, DC 20010
Phone (202) 877-3901

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785

2041 Georgia Ave NW
#1400
Washington, DC 20060
Phone (202) 865-1141

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356198741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 L ST NW APT 914",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371531",
            "telephone_number": "810-919-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW # 1-400",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600002",
            "telephone_number": "202-865-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERHOUSE",
        "first_name": "ELIZABETH",
        "middle_name": "KATHRYN",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.