Individual provider Active NPI

Elizabeth Erin Nelsen, MD

  • Pediatrics Physician
  • Lebanon, NH
National Provider Identifier
1457514192
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34542 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5000
Fax
(603) 650-5000
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 245637 NY
Pediatrics Physician 208000000X 34542 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 653-6060

Other identifiers 1

IdentifierTypeStateIssuer
03237905MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100928001701 NY Practitioner - Pediatric Medicine 5799801684 Reassigns benefits to 1 organization
I20250807003503 NH Practitioner - Pediatric Medicine 5799801684 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34542NHMDPediatrics Physician
245637NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 4, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 4, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Aug 4, 2025 Accepting new patients
Pediatric Service Group Pediatrics CurrentSince Jul 1, 2010 Accepting new patients

Locations

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

725 E Adams St
Fl 4
Syracuse, NY 13210
Phone (315) 464-4686

90 Presidential Plz
Fl 3
Syracuse, NY 13202
Phone (315) 464-4357

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1457514192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5000",
            "fax_number": "603-650-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN",
        "first_name": "ELIZABETH",
        "middle_name": "ERIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "245637",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "34542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03237905",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.