Individual provider Active NPI

Elizabeth K Mentzer, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1578889663
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1557 Issued in KY
Practice address
989 Governors LN Ste 240
Lexington, KY 40513-1175
Phone
(859) 338-3958
Fax
(859) 368-8135
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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 PA1557 KY Primary

Addresses

Primary practice location

989 Governors LN Ste 240
Lexington, KY 40513-1175

Mailing address

989 Governors LN Ste 240
Lexington, KY 40513-1175
Phone (859) 338-3958

Other practice location 1

989 Governors Ln Ste 220
Lexington, KY 40513-1175
Phone (859) 447-8014

Other identifiers 1

IdentifierTypeStateIssuer
7100137000MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100729000041 KY Practitioner - Physician Assistant 1456484351 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bluegrass Extended Care Services LLCGroup PAC ID 4688832090, 7 clinicians

Practice addresses (Care Compare)

989 Governors LN
Suite 220
Lexington, KY 40513-1175
Phone (859) 447-8014

Hospital & facility affiliations

  • Baptist Health Lexington Hospital, Lexington, KY, CCN 180103

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot One Primary Care PSC Current Accepting new patients

Locations

989 Governors Ln
Ste 220
Lexington, KY 40513
Phone (859) 296-7546

Organizations & group practices 4

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": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1578889663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 240",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-338-3958",
            "fax_number": "859-368-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 240",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-338-3958",
            "fax_number": "859-368-8135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "989 Governors Ln Ste 220",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405131175",
            "country_code": "US",
            "telephone_number": "859-447-8014",
            "fax_number": "859-447-8013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "ELIZABETH",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100137000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.