Elizabeth Le Wannebo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD434557 Issued in PA

Practice address

1011 Boyds School Rd
Gettysburg, PA 17325-8580

Phone

(859) 327-0671

NPI assigned

Jun 10, 2008

Last updated

Dec 23, 2013By 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 2

Addresses

Other identifiers 7

Other names 1

• Elizabeth Ngoc Le Former name

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Mississippi School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cogent Healthcare of Montana P CGroup PAC ID 4486712833, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cogent Healthcare of Montana P C

  • Internal Medicine Physician
  • Missoula, MT
  • NPI 1053569525
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Montana - TCS PC

  • Internal Medicine Physician
  • Butte, MT
  • NPI 1902567183
  Medicare reassignment NPD
• SCL Health Montana

  dba Intermountain Health St Vincent Regional Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Medicare reassignment NPD
• SCL Health Montana

  dba SVPN North Shiloh

  • Multi-Specialty Clinic/Center
  • Billings, MT
  • NPI 1922039890
  NPD
• St. Vincent Healthcare

  dba MT Heart Institute

  • Interventional Cardiology Physician
  • Billings, MT
  • NPI 1760819486
  NPD
• Wellspan Medical Group

  dba WellSpan Pediatric Surgical Specialist

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• SCL Health Montana

  dba Intermountain Health St Vincent Regional Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Care Compare affiliation
• St. Vincent Healthcare

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1396916276
  Care Compare affiliation

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1700046190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOYDS SCHOOL RD",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173258580",
            "telephone_number": "859-327-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOYDS SCHOOL RD",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173258580",
            "telephone_number": "859-327-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNEBO",
        "first_name": "ELIZABETH",
        "middle_name": "LE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD434557",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD434557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018317200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9928179",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "120275",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2056156",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102170568",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "211210",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "935776",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LE",
            "middle_name": "NGOC",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Internal Medicine Physician in Gettysburg, PA
• Providers in Gettysburg, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.