NPIMap

Individual provider Active NPI

Elizabeth A Eldenburg, PA-C

  • Surgical Physician Assistant
  • Federal Way, WA
National Provider Identifier
1447720974
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60910425 Issued in WA
Practice address
34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708
Phone
(253) 835-5510
Fax
(253) 835-5511
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60910425 WA
Surgical Physician Assistant 363AS0400X 60910425 WA
Surgical Physician Assistant 363AS0400X PA60910425 WA Primary

Addresses

Primary practice location

34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708

Mailing address

34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708
Phone (253) 835-5510

Other practice location 1

505 NE 87th Ave Ste 250
Vancouver, WA 98664-1965
Phone (360) 514-1010

Other names 1

  • Ms. Elizabeth A Granada Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eeldenburg663738@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124003285 WA Practitioner - Physician Assistant 6901143247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
Tacoma, WA 98405-4930

1617 S J St
Tacoma, WA 98405-4930
Phone (253) 426-6306

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

34503 9TH Ave S
Federal Way, WA 98003-8726

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 944-7977

Hospital & facility affiliations

  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60910425WAMDSurgical Physician Assistant
PA60910425WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Mar 22, 2021 Accepting new patients
Franciscan Medical Group CurrentSince Mar 22, 2021 Accepting new patients
Columbia Anesthesia Group P S Past Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

16259 Sylvester Rd SW
Ste 401
Burien, WA 98166
Phone (206) 242-8837

34503 9th Ave S
Ste 320
Federal Way, WA 98003
Phone (253) 627-2900

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34509 9th Ave S
Ste 204
Federal Way, WA 98003
Phone (253) 835-5510

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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 6

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1447720974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S STE 204",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038708",
            "telephone_number": "253-835-5510",
            "fax_number": "253-835-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S STE 204",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038708",
            "telephone_number": "253-835-5510",
            "fax_number": "253-835-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 NE 87th Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDENBURG",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60910425",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "60910425",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60910425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eeldenburg663738@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34509 9th Ave S Ste 204",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980038708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GRANADA",
            "middle_name": "A",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.