Individual provider Active NPI

Elizabeth Hayes, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1417235441
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
675 N Saint Clair St
#100
Chicago, IL 60611-5975
Phone
(312) 926-2000
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X IL Primary
Physician Assistant 363A00000X 5601012287 MI

Addresses

Primary practice location

675 N Saint Clair St
#100
Chicago, IL 60611-5975

Mailing address

1110 W Newport Ave Apt CH
Chicago, IL 60657-1564
Phone (616) 481-8414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130620000429 IL Practitioner - Physician Assistant 2365681418
I20240517000327 MI Practitioner - Physician Assistant 2365681418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

416 Connable Ave
Petoskey, MI 49770-2212
Phone (800) 248-6777

Hospital & facility affiliations

  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012287MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Northern Michigan CurrentSince Jul 22, 2024 Accepting new patients
McLaren Central Michigan CurrentSince Mar 26, 2025 Accepting new patients
McLaren Central Michigan CurrentSince Mar 26, 2025 Accepting new patients
McLaren Northern Michigan CurrentSince Jul 22, 2024 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

560 W Mitchell St
Ste 400
Petoskey, MI 49770
Phone (231) 330-3585

Organizations & group practices 6

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 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": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1417235441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W NEWPORT AVE APT CH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571564",
            "telephone_number": "616-481-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "#100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.