NPIMap

Individual provider Active NPI

Elizabeth M Poli, ARNP

  • Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1639650138
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60882915 Issued in WA
Practice address
307 S 13TH St
Mount Vernon, WA 98274-4100
Phone
(360) 814-2146
Fax
(360) 814-2445
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60882915 WA Primary

Addresses

Primary practice location

307 S 13TH St
Mount Vernon, WA 98274-4100

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address epoli38744@skagit.direct-ci.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190104002414 WA Practitioner - Nurse Practitioner 0941546329 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, shared by 7 NPIs, 321 clinicians

Practice addresses (Care Compare)

307 S 13TH St
Suite 100
Mount Vernon, WA 98274-4100
Phone (360) 814-2146

3823 172ND St NE
Arlington, WA 98223-7735
Phone (360) 651-8365

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 10, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince May 6, 2022 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 11, 2018 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 11, 2018 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince May 6, 2022 Accepting new patients

Locations

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

1717 13th St
Everett, WA 98201
Phone (425) 297-5500

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

307 S 13th St
Ste 100
Mount Vernon, WA 98274
Phone (360) 424-2630

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

307 S 13th St
Mount Vernon, WA 98274
Phone (360) 336-9757

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: epoli38744@skagit.direct-ci.com

Organizations & group practices 5

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 9

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1639650138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-814-2146",
            "fax_number": "360-814-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLI",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60882915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epoli38744@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "307 S 13th St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.