Elizabeth Tibbs, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10002453A Issued in IN

Practice address

10590 N Meridian St Ste 105
Indianapolis, IN 46290

Phone

(317) 583-7800

NPI assigned

Mar 30, 2015

Last updated

May 23, 2022By 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 4

Addresses

Other names 1

• Elizabeth Hazlehurst Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent Heart Center Hospital, Carmel, IN, CCN 150153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375
  Medicare reassignment Care Compare group
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1033999370
  NPD
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD
• Corvasc MDS PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Indianapolis, IN
  • NPI 1710902671
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• St. Vincent Heart Center of Indiana, LLC

  dba Ascension St. Vincent Heart Center

  • Special Hospital
  • Carmel, IN
  • NPI 1982681748
  Care Compare affiliation

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1801281670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST # 105",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462901028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST STE 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46290",
            "telephone_number": "317-583-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11481",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA-1038",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002453A",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10002453A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.tibbs.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "10590 N Meridian St Ste 105",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HAZLEHURST",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia Tial
• Philmarlon Logatoc Tiamson, PT
• Aislinn Xiaoen Tian
• Jianmin Tian, MD
• Hannah Tibbets
• Eric E Tibesar, MD
• Maria Paulina Tiburcio-Ojeda
• Carmen Tichindelean, MD
• Teresa M Tidd, CST/CFA
• Jazmyne Tidwell, LMHC

• Surgical Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Surgical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.