Individual provider Active NPI

Elizabeth A Tateoka, DNP

  • Acute Care Nurse Practitioner
  • Gardner, MA
National Provider Identifier
1427505155
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2336656 Issued in MA
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(860) 937-0378
NPI assigned
Sep 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2336656 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

354 Main St Unit 5
Gardner, MA 01440-3055
Phone (860) 937-0378

Other practice location 1

354 Main St Unit 5
Gardner, MA 01440-3055
Phone (860) 937-0378

Other identifiers 1

IdentifierTypeStateIssuer
RN2336656OtherMASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200518001145 MA Practitioner - Nurse Practitioner 9234410267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians

Practice addresses (Care Compare)

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

Hospital & facility affiliations

  • Heywood Hospital - Hospital, Gardner, MA, CCN 220095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2336656MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athol Memorial Hospital Incorporated Acute Care CurrentSince Aug 1, 2020 Accepting new patients
Henry Heywood Memorial Hospital Acute Care CurrentSince Aug 1, 2020 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

Organizations & group practices 3

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": "1473552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1427505155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MAIN ST UNIT 5",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403055",
            "telephone_number": "860-937-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "860-937-0378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Main St Unit 5",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014403055",
            "country_code": "US",
            "telephone_number": "860-937-0378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATEOKA",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-11",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2336656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN2336656",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.