Active NPI
Elizabeth Kull Czako, CFNP
- Nurse Practitioner
- Wellsboro, PA
National Provider Identifier
1730158288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP003877B
- Practice address
- 7 Water St
Wellsboro, PA 16901-1126 - Phone
- (570) 724-4241
- Fax
- (570) 724-5510
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F331424-1 | NY | |
| Nurse Practitioner | 363L00000X | SP003877B | PA | Primary |
Addresses
Primary practice location
7 Water St
Wellsboro, PA 16901-1126
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01678028 | Medicaid | NY | |
| GU039777 | Other | PA | MEDICARE GROUP |
| CC9269 | Other | PA | RR MEDICARE GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F331424-1 | NY | MD | Nurse Practitioner |
| SP003877B | PA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group PC | Past | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients | |
| Guthrie Clinic LTD | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Endoscopy Clinic/Center
- Sayre, PA
- NPI 1831144047
-
- Clinical Medical Laboratory
- Sayre, PA
- NPI 1649225855
-
- General Practice Physician
- Sayre, PA
- NPI 1245246644
-
- Family Medicine Physician
- Troy, PA
- NPI 1376592493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206576000000",
"number": "1730158288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858",
"fax_number": "570-882-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 WATER ST",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011126",
"telephone_number": "570-724-4241",
"fax_number": "570-724-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZAKO",
"first_name": "ELIZABETH",
"middle_name": "KULL",
"name_prefix": "Ms.",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2008-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F331424-1",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP003877B",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01678028",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "GU039777",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC9269",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wellsboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.