Individual provider Active NPI

Elizabeth Pulawski, MD

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1417029869
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036071954 Issued in IL
Practice address
5801 Braden Run
Bradenton, FL 34202-9402
Phone
(941) 727-1500
Fax
(941) 727-1509
NPI assigned
Nov 14, 2006
Last updated
Nov 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036071954 IL Primary

Addresses

Primary practice location

5801 Braden Run
Bradenton, FL 34202-9402

Mailing address

5801 Braden Run
Bradenton, FL 34202-9402
Phone (941) 727-1500

Other identifiers 2

IdentifierTypeStateIssuer
036071954OtherILSTATE LICENSE
623540OtherFLSTATE LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181221000419 FL Practitioner - Family Practice 2961583711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alternative P.T.,Inc.Group PAC ID 0042114332, 3 clinicians

Practice addresses (Care Compare)

5801 Braden Run
Bradenton, FL 34202-9402
Phone (941) 727-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036071954ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative P.T.,Inc. CurrentSince Dec 1, 2018 Accepting new patients

Locations

5801 Braden Run
Bradenton, FL 34202
Phone (941) 727-1500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1417029869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BRADEN RUN",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342029402",
            "telephone_number": "941-727-1500",
            "fax_number": "941-727-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BRADEN RUN",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342029402",
            "telephone_number": "941-727-1500",
            "fax_number": "941-727-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULAWSKI",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036071954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036071954",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "623540",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.