Elli Roberts, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15-01778 Issued in KS

Practice address

7450 Kessler St Ste 300
Shawnee Mission, KS 66204-2550

Phone

(913) 632-2900

Fax

(913) 632-2999

NPI assigned

Feb 3, 2015

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elli Mathis Former name

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Mission Medical Center IncGroup PAC ID 9537119037, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
• Adventhealth South Overland Park, Inc Hospital, Overland Park, KS, CCN 170208

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eroberts1148668@adventhealth.direct-ci.com

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.

• Shawnee Mission Medical Center Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690

  Medical

  Medicare reassignment Care Compare group NPD
• Shawnee Mission Medical Center, Inc.

  dba AdventHealth Centra Care

  • Urgent Care Clinic/Center
  • Shawnee, KS
  • NPI 1942317854
  NPD (past)

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

• Adventhealth South Overland Park, Inc.

  dba AdventHealth South Overland Park

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1316536253
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  dba AdventHealth Shawnee Mission

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1578953162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 KESSLER ST STE 300",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042550",
            "telephone_number": "913-632-2900",
            "fax_number": "913-632-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 KESSLER ST STE 300",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042550",
            "telephone_number": "913-632-2900",
            "fax_number": "913-632-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9119 W 74th St",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Shawnee Mission",
            "state": "KS",
            "postal_code": "662042215",
            "country_code": "US",
            "telephone_number": "913-789-1986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ELLI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-01778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLI",
            "last_name": "MATHIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Don G Richter, M.D.
• Leah Dooley Ridgway, M.D.
• Jill Lynne Riffel, M.D.
• Tom Riggs, MPT, CSCS
• William S Ritter, M.D.
• Montgomery L Roberts, D.O.
• Amanda Nicole Robinson, D.O.
• John Robinson, M.D.
• Jillian Roedel, PHARMD
• Andrea Rosewell, CRNA

• Medical Physician Assistant in Shawnee Mission, KS
• Providers in Shawnee Mission, KS by specialty
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.