Individual provider Active NPI

Elise Sharkey, PA-C

  • Physician Assistant
  • Goshen, IN
National Provider Identifier
1528798659
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003711A Issued in IN
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(574) 364-2888
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 10003711A IN Primary

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elise.sharkey@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220830000427 IN Practitioner - Physician Assistant 5294119970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003711AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc CurrentSince Aug 26, 2022 Accepting new patients
Goshen Hospital Association Inc Current Accepting new patients

Locations

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

Interoperability endpoints

  • Direct secure messaging: elise.sharkey@goshenhealthdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1528798659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARKEY",
        "first_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003711A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elise.sharkey@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "200 High Park Ave",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.