Individual provider Active NPI

Elizabeth Cassidy, PA-C

  • Physician Assistant
  • Beverly, MA
National Provider Identifier
1639421308
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4477 Issued in MA
Practice address
77 Herrick St Ste 201
Beverly, MA 01915-2796
Phone
(978) 927-3040
Fax
(978) 927-0443
NPI assigned
Oct 5, 2012
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 PA4477 MA Primary

Addresses

Primary practice location

77 Herrick St Ste 201
Beverly, MA 01915-2796

Mailing address

77 Herrick St Ste 201
Beverly, MA 01915-2796
Phone (978) 927-3040

Other names 1

  • Elizabeth Terlik Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130205000383 MA Practitioner - Physician Assistant 4789838483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

152 Conant St
Suite 301
Beverly, MA 01915-1659
Phone (978) 927-3040

99 Conifer Hill Dr
Suite 204
Danvers, MA 01923-1194
Phone (978) 927-3040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA4477MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedic Associates Inc CurrentSince Sep 1, 2022 Accepting new patients
Cambridge Public Health Commission CurrentSince Jul 14, 2015 Accepting new patients

Locations

152 Conant St
Ste 301
Beverly, MA 01915
Phone (978) 927-3040

77 Herrick St
Ste 201
Beverly, MA 01915
Phone (978) 927-3040

99 Conifer Hill Dr
Ste 204
Danvers, MA 01923
Phone (978) 927-3040

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

1 Blackburn Dr
Gloucester, MA 01930
Phone (978) 282-3698

Interoperability endpoints

  • Direct secure messaging: elizabeth.cassidy.1@30242.direct.athenahealth.com

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 3

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": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1639421308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST STE 201",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152796",
            "telephone_number": "978-927-3040",
            "fax_number": "978-927-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST STE 201",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152796",
            "telephone_number": "978-927-3040",
            "fax_number": "978-927-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TERLIK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.