Individual provider Active NPI

Elizabeth A Sanders, RD, RDN, PA-C

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1558779199
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA200001507 Issued in DC
Practice address
1310 Southern Ave SE
Washington, DC 20032-4623
Phone
(202) 715-4000
NPI assigned
Jul 28, 2014
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA200001507 DC
Medical Physician Assistant 363AM0700X PA200001507 DC Primary
Registered Dietitian 133V00000X L004347 NC

Addresses

Primary practice location

1310 Southern Ave SE
Washington, DC 20032-4623

Mailing address

1100 New Jersey Ave SE Ste 500
Washington, DC 20003-3326
Phone (724) 396-6921

Other practice location 1

208 Foust St
Asheboro, NC 27203-5499
Phone (336) 625-9400

Other practice location 2

1901 D St SE Fl 3
Washington, DC 20003-2534
Phone (202) 698-0400

Other identifiers 3

IdentifierTypeStateIssuer
86053639OtherNCACADEMY OF NUTRITION AND DIETETICS - RD, RDN
L004347OtherNCNC BOARD OF DIETETICS/NUTRITION - LDN
PA200001507OtherDCDC DEPARTMENT OF HEALTH, BOARD OF MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20230713000614 DC Practitioner - Physician Assistant 9537529250 Reassigns benefits to 2 organizations

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
Mid Atlantic Medicine LLCGroup PAC ID 6204202864, 14 clinicians

Practice addresses (Care Compare)

2228 Martin Luther King Jr Ave SE
Washington, DC 20020-5700
Phone (202) 715-4470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L004347NCMDRegistered Dietitian

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.

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1558779199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NEW JERSEY AVE SE STE 500",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033326",
            "telephone_number": "724-396-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-715-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Foust St",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272035499",
            "country_code": "US",
            "telephone_number": "336-625-9400",
            "fax_number": "336-625-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 D St SE Fl 3",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200032534",
            "country_code": "US",
            "telephone_number": "202-698-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "RD, RDN, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001507",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA200001507",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004347",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACADEMY OF NUTRITION AND DIETETICS - RD, RDN",
            "identifier": "86053639",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF DIETETICS/NUTRITION - LDN",
            "identifier": "L004347",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC DEPARTMENT OF HEALTH, BOARD OF MEDICINE",
            "identifier": "PA200001507",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.