Active NPI
Elizabeth A Lulloff, CRNA
- Certified Registered Nurse Anesthetist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 3193-33
- Practice address
- 835 South Vanburen Street
Green Bay, WI 54301-3505 - Phone
- (920) 433-0111
- NPI assigned
- Aug 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3193-033 | WI | |
| Certified Registered Nurse Anesthetist | 367500000X | 3193-33 | WI | Primary |
Addresses
Primary practice location
835 South Vanburen Street
Green Bay, WI 54301-3505
Mailing address
835 S. Vanburen Street
Green Bay, WI 54301-3400
Phone (920) 433-0111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376736660 | Medicaid | WI | |
| 141374-030 | Other | WI | RN |
Other names 1
- Elizabeth A Cavil
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | elulloff113257@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111
Hospital & facility affiliations
- St Vincent Hospital
- St Marys Hospital Medical Ctr
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.22 of 100
- Quality
- 69.67
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3193-033 | WI | MD | Nurse Practitioner |
| 3193-33 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Bay Radiology SC | Current | Accepting new patients |
Locations
835 S Van Buren St
#13508
Green Bay, WI 54301
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
Interoperability endpoints
- elulloff113257@ewd.direct.hshs.org
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Green Bay, WI
- NPI 1023065836
-
- Diagnostic Radiology Physician
- Green Bay, WI
- NPI 1447327986
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1649246877
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1114908001
-
- Hematology & Oncology Physician
- Sheboygan, WI
- NPI 1831784636
Hospital
-
- Hematology & Oncology Physician
- Green Bay, WI
- NPI 1184004236
Hospital
-
- Hematology & Oncology Physician
- Oconto Falls, WI
- NPI 1750760740
Hospital
-
- Hematology & Oncology Physician
- Sturgeon Bay, WI
- NPI 1760861751
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1376736660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 S. VANBUREN STREET",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013400",
"telephone_number": "920-433-0111",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 SOUTH VANBUREN STREET",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013505",
"telephone_number": "920-433-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LULLOFF",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2021-12-28",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "3193-033",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "3193-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1376736660",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "141374-030",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "elulloff113257@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "835 South VanBuren Street",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543013505",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "CAVIL",
"middle_name": "A",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.