Individual provider Active NPI

Elizabeth Ashley Taylor, PA-C, ATC

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1780917401
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
974 Issued in AK
Practice address
3340 Providence Dr Ste 358
Anchorage, AK 99508-4627
Phone
(907) 268-2067
Fax
(855) 395-0858
NPI assigned
Sep 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2119 AK
Physician Assistant 363A00000X 974 AK Primary

Addresses

Primary practice location

3340 Providence Dr Ste 358
Anchorage, AK 99508-4627

Mailing address

3340 Providence Dr Ste 358
Anchorage, AK 99508-4627
Phone (907) 268-2067

Other identifiers 1

IdentifierTypeStateIssuer
1575278MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 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
I20111108000691 AK Practitioner - Physician Assistant 3072652338 Reassigns benefits to 1 organization
I20200818004068 TX Practitioner - Physician Assistant 3072652338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Family Dermatology LLC 2 clinicians

Practice addresses (Care Compare)

3340 Providence Dr
Suite A358
Anchorage, AK 99508-4691
Phone (907) 268-2067

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2119AKMDPhysician Assistant
974AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Jun 22, 2020 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

Interoperability endpoints

  • Direct secure messaging: etaylor88787@ak.providencedirect.org

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 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": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1780917401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR STE 358",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084627",
            "telephone_number": "907-268-2067",
            "fax_number": "855-395-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR STE 358",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084627",
            "telephone_number": "907-268-2067",
            "fax_number": "855-395-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ELIZABETH",
        "middle_name": "ASHLEY",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "2119",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575278",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.