Individual provider Active NPI

Elizabeth J Eaton, PA

  • Physician Assistant
  • Kittery, ME
National Provider Identifier
1386119469
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1407 Issued in NH
Practice address
402 Goodrich Ave
Kittery, ME 03904
Phone
(207) 498-5981
NPI assigned
Oct 4, 2018
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 1407 NH Primary

Addresses

Primary practice location

402 Goodrich Ave
Kittery, ME 03904

Mailing address

Nmrtu - Portsmouth
402 Goodrich Ave
Kittery, ME 03904
Phone (207) 438-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20181030002555 NH Practitioner - Physician Assistant 4981957446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1407NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Emergency Physicians PC CurrentSince Oct 3, 2018 Accepting new patients

Locations

701 Central Ave
Dover, NH 03820
Phone (603) 609-6700

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

65 Calef Hwy
Lee, NH 03861
Phone (603) 740-2250

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, 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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1386119469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NMRTU - PORTSMOUTH",
            "address_2": "402 GOODRICH AVE",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "03904",
            "telephone_number": "207-438-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 GOODRICH AVE",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "03904",
            "telephone_number": "207-498-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittery, ME

Sources for this page

Verify at the official NPI Registry.