Individual provider Active NPI

Elizabeth Marie Mikuszewski, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Geneva, NY
National Provider Identifier
1508063140
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011948 Issued in NY
Practice address
196 North St
Geneva, NY 14456-1651
Phone
(315) 787-4000
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011948 NY Primary

Addresses

Primary practice location

196 North St
Geneva, NY 14456-1651

Mailing address

376 Pearl St
Rear Apt
Rochester, NY 14607-3732
Phone (716) 969-4087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20071120000246 NY Practitioner - Physician Assistant 2365530615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva General Hospital, IncGroup PAC ID 7810809407, 88 clinicians

Practice addresses (Care Compare)

196 198 N St
Geneva, NY 14456-1694
Phone (315) 789-4222

196 N St
Geneva, NY 14456-1651
Phone (315) 787-5355

196 N St
Geneva, NY 14456-1694

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011948NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva General Hospital CurrentSince Oct 14, 2009 Accepting new patients
Geneva General Hospital, Inc CurrentSince Oct 14, 2009 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital Inc. Past Accepting new patients

Locations

196 North St
Geneva, NY 14456
Phone (315) 787-4156

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1508063140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 PEARL ST",
            "address_2": "REAR APT",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146073732",
            "telephone_number": "716-969-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 NORTH ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561651",
            "telephone_number": "315-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKUSZEWSKI",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.