Individual provider Active NPI

Colin R Elie, PA-C

  • Physician Assistant
  • Palo Alto, CA
National Provider Identifier
1689275059
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58846 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 58846 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Other practice location 1

2200 NE Neff Rd Ste 200
Bend, OR 97701-4281
Phone (541) 382-3344

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address colinelie@tc.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220323001440 OR Practitioner - Physician Assistant 2264827526
I20221121000608 CA Practitioner - Physician Assistant 2264827526 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology and Interventional Associates IncGroup PAC ID 2163816448, 99 clinicians

Practice addresses (Care Compare)

1800 N California St
Stockton, CA 95204-6019
Phone (209) 943-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58846CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology and Interventional Associates Inc CurrentSince Oct 1, 2025 Accepting new patients
Stanford Health Care CurrentSince Nov 1, 2022 Accepting new patients
Stanford Health Care CurrentSince Nov 1, 2022 Accepting new patients
Port City Operating Company, LLC Past Accepting new patients

Locations

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

450 Glass Ln
Ste C
Modesto, CA 95356

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

1617 N California St
Ste 1A
Stockton, CA 95204
Phone (209) 467-6363

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

607 E Magnolia St
Stockton, CA 95202
Phone (209) 616-6600

3439 Brookside Rd
Ste 107
Stockton, CA 95219
Phone (209) 466-5027

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

Organizations & group practices 6

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": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1689275059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 NE Neff Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977014281",
            "country_code": "US",
            "telephone_number": "541-382-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIE",
        "first_name": "COLIN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colinelie@tc.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2200 NE Neff Rd Ste 200",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.