Amy L Ellsworth, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61202127 Issued in WA

Practice address

1100 9TH Ave
Seattle, WA 98101-2756

Phone

(206) 583-2299

NPI assigned

Nov 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.ellsworthpac.p79@direct.kootenai.nextgenshare.com
• Direct secure messaging: aellsworth609887@direct.multicare.org

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.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment
• Virginia Mason Medical Center

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1487908786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-583-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Ironwood Avenue",
            "address_2": "Suite 334",
            "address_purpose": "LOCATION",
            "city": "Coeur d'Alene",
            "state": "ID",
            "postal_code": "83814",
            "country_code": "US",
            "telephone_number": "509-838-2531 x50975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 Lincoln Way Ste 110",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142527",
            "country_code": "US",
            "telephone_number": "208-625-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1022",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61202127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.ellsworthpac.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way Ste 110",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Dora Ellison, DC
• Michelle Elliston, RDN
• Seth Jon Ellner, MSW
• Kathleen E Ellsbury
• Allan J. Ellsworth, PA-C
• Hannah Elizabeth Ellsworth, ARNP
• Alaa Adel Elmaoued, MD
• Sara Elmarakshy, R.PH.
• Sahra Elmi
• Lindsey Ann Elmore, MS LMFT

• Medical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.