NPIMap

Individual provider Active NPI

Elizabeth A Mayer, PA-C

  • Medical Physician Assistant
  • Perrysburg, OH
National Provider Identifier
1528017076
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5000158 Issued in OH
Practice address
28555 Starbright Blvd
Suite B
Perrysburg, OH 43551-5662
Phone
(419) 931-3030
Fax
(419) 931-3046
NPI assigned
May 10, 2006
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5000158 OH Primary

Addresses

Primary practice location

28555 Starbright Blvd
Suite B
Perrysburg, OH 43551-5662

Mailing address

28555 Starbright Blvd
Suite B
Perrysburg, OH 43551-5662
Phone (419) 931-3030

Other identifiers 3

IdentifierTypeStateIssuer
0067679MedicaidOH
000000660552OtherBCBS
P00808415OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050707000289 OH Practitioner - Physician Assistant 5799765277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2222 Cherry St
Toledo, OH 43608-2675

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5000158OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC CurrentSince Nov 30, 2018 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Nov 30, 2018 Accepting new patients
Burlen Family Practice and Wellness Center Physician Assistant Past Accepting new patients

Locations

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

Interoperability endpoints

  • Direct secure messaging: emayer110961@direct.bsmhealth.org

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.

Hospital & facility affiliations 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1528017076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD",
            "address_2": "SUITE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD",
            "address_2": "SUITE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "5000158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067679",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000660552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00808415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.