Individual provider Active NPI

Elizabeth Anne Wuerslin, MD

  • Pediatrics Physician
  • Fort Collins, CO
National Provider Identifier
1366550154
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31325 Issued in CO
Practice address
1524 Rolf CT
Fort Collins, CO 80525-1220
Phone
(970) 494-1336
NPI assigned
Aug 29, 2006
Last updated
Feb 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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 31325 CO Primary

Addresses

Primary practice location

1524 Rolf CT
Fort Collins, CO 80525-1220

Mailing address

1524 Rolf CT
Fort Collins, CO 80525-1220
Phone (970) 494-1336

Other identifiers 2

IdentifierTypeStateIssuer
01313253MedicaidCO
30325OtherCOMD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220810001255 WI Practitioner - Pediatric Medicine 2466400114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31325COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jul 2, 2022 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Jul 2, 2022 Accepting new patients
Family Physical Therapy Center, P.C. Past Accepting new patients
Door County Memorial Hospital Past Accepting new patients
Memorial Hospital of Sweetwater County Past Accepting new patients
Memorial Hospital of Sweetwater County Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1366550154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 ROLF CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251220",
            "telephone_number": "970-494-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 ROLF CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251220",
            "telephone_number": "970-494-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUERSLIN",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "31325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01313253",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "30325",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.