Individual provider Active NPI

Elizabeth Lokenauth, PA

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1487321790
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117592 Issued in FL
Practice address
3060 Loopdale LN
Kissimmee, FL 34741-7659
Phone
(407) 775-2121
Fax
(888) 272-4324
NPI assigned
Aug 24, 2021
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027274-01 NY
Physician Assistant 363A00000X PA9117592 FL Primary

Addresses

Primary practice location

3060 Loopdale LN
Kissimmee, FL 34741-7659

Mailing address

311 North St Ste 201
White Plains, NY 10605-2232
Phone (914) 629-3100

Other practice location 1

311 North St Ste 201
White Plains, NY 10605-2232
Phone (914) 629-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20211208002413 NY Practitioner - Physician Assistant 2163812058 Reassigns benefits to 1 organization
I20231101000097 FL Practitioner - Physician Assistant 2163812058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mava Healthcare Systems LLCGroup PAC ID 8123448313, 7 clinicians

Practice addresses (Care Compare)

2971 Park Pond Way
Kissimmee, FL 34741-7661
Phone (407) 775-2121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027274NYMDClinical Psychologist
PA9117592FLMDPhysician Assistant
027274-01NYMDPhysician Assistant

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: elokenauth1465297@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1487321790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 201",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052232",
            "telephone_number": "914-629-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 LOOPDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417659",
            "telephone_number": "407-775-2121",
            "fax_number": "888-272-4324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 North St Ste 201",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106052232",
            "country_code": "US",
            "telephone_number": "914-629-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOKENAUTH",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027274-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.