Individual provider Active NPI

Elizabeth Sibrack, M.D.

  • Pediatrics Physician
  • Walnut Creek, CA
National Provider Identifier
1538556873
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
161368 Issued in CA
Practice address
1425 S Main St
Walnut Creek, CA 94596
Phone
(925) 295-4000
NPI assigned
Apr 24, 2015
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 161368 CA Primary
Internal Medicine Physician 207R00000X 161368 CA
Hospitalist Physician 208M00000X 0101286933 VA

Addresses

Primary practice location

1425 S Main St
Walnut Creek, CA 94596

Mailing address

PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844

Other practice location 1

1250 E Marshall St
Richmond, VA 23298-5023
Phone (840) 828-2467

Other practice location 2

Unc Med Peds Residency Program
230 MacNider, CB #7593
Chapel Hill, NC 27599-7593
Phone (919) 966-6770

Other practice location 3

1000 E Broad St
Richmond, VA 23219-1930
Phone (804) 828-2467

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104000026 VA Practitioner - Internal MedicinePractitioner - Hospitalist 0749501096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

1643 NW 136TH Ave
Sunrise, FL 33323-2857

PO Box
Philadelphia, PA 19178

PO Box
Suite 980503
Richmond, VA 23298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
161368CAMDInternal Medicine Physician
0101286933VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Multi-Specialty CurrentSince Dec 8, 2025 Accepting new patients
Southeastern Intensivist Services PC Multi-Specialty CurrentSince Nov 1, 2025 Accepting new patients

Locations

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

1000 E Broad St
Richmond, VA 23219

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

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, 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": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1538556873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "804-922-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S MAIN ST",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-295-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985023",
            "country_code": "US",
            "telephone_number": "840-828-2467",
            "fax_number": "804-628-5847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Unc Med Peds Residency Program",
            "address_2": "230 MacNider, CB #7593",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275997593",
            "country_code": "US",
            "telephone_number": "919-966-6770",
            "fax_number": "919-966-8419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232191930",
            "country_code": "US",
            "telephone_number": "804-828-2467",
            "fax_number": "804-628-5847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBRACK",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "161368",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "161368",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101286933",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 South Main Street",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.