NPIMap

Individual provider Active NPI

Erik P Sivertsen, PA-C

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1548579147
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA8935 Issued in MA
Practice address
2 Medical Center Dr Ste 512
Springfield, MA 01107-1273
Phone
(413) 794-5550
Fax
(413) 794-4212
NPI assigned
Sep 29, 2010
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9765 AZ
Surgical Physician Assistant 363AS0400X PA3383 KY
Surgical Physician Assistant 363AS0400X PA8935 MA Primary

Addresses

Primary practice location

2 Medical Center Dr Ste 512
Springfield, MA 01107-1273

Mailing address

280 Chestnut Street
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

201 Abraham Flexner Way Ste 1200
Louisville, KY 40202-3841
Phone (502) 721-5899

Other practice location 2

2460 S Parkview Loop Ste 203
Yuma, AZ 85364-5358
Phone (928) 336-2619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, AZ, KY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110111000686 UT Practitioner - Physician Assistant 1153510821 Reassigns benefits to 1 organization
I20230831004474 AZ Practitioner - Physician Assistant 1153510821 Reassigns benefits to 1 organization
I20240920002323 KY Practitioner - Physician Assistant 1153510821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9765AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Jul 17, 2023 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 31, 2024 Accepting new patients
Valley Women's Health Group, LLC CurrentSince Feb 12, 2023 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 31, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Mar 1, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Mar 1, 2017 Accepting new patients
Summit Pain Management PC Past Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

2460 S Parkview Loop
Ste 203
Yuma, AZ 85364
Phone (928) 336-2619

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

2 Medical Center Dr
Ste 512
Springfield, MA 01107
Phone (413) 732-2311

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 10

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1548579147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CENTER DR STE 512",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071273",
            "telephone_number": "413-794-5550",
            "fax_number": "413-794-4212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Abraham Flexner Way Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023841",
            "country_code": "US",
            "telephone_number": "502-721-5899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2460 S Parkview Loop Ste 203",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853645358",
            "country_code": "US",
            "telephone_number": "928-336-2619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVERTSEN",
        "first_name": "ERIK",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9765",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3383",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA8935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.