NPIMap

Individual provider Active NPI

Elizabeth Ann Gormley, M.D.

  • Urology Physician
  • Lebanon, NH
National Provider Identifier
1457465189
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
9038 Issued in NH
Practice address
1 Medical Center Dr
Section of Urology
Lebanon, NH 03756-1000
Phone
(603) 650-6053
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 9038 NH Primary
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 9038 NH

Addresses

Primary practice location

1 Medical Center Dr
Section of Urology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Section of Urology, Dartmouth-Hitchcock Medical Center
Lebanon, NH 03756-1000
Phone (603) 650-6053

Other identifiers 2

IdentifierTypeStateIssuer
0RE2822MedicaidVT
99002822MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20060307000430 NH Practitioner - Urology 1850308461 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

PO Box
Suite 810
Hanover, NH 03755-0810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 7, 1993 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 7, 1993 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Feb 20, 2013 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 7, 1993 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

Interoperability endpoints

  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: egormley13128@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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 12

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1457465189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "SECTION OF UROLOGY, DARTMOUTH-HITCHCOCK MEDICAL CENTER",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6053",
            "fax_number": "603-650-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "SECTION OF UROLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "9038",
            "primary": true
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NH",
            "license": "9038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0RE2822",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99002822",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.