Individual provider Active NPI

Elizabeth Ann Bross, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1811030802
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052909 Issued in PA
Practice address
205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619
Phone
(717) 231-8555
Fax
(717) 231-8568
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052909 PA Primary

Addresses

Primary practice location

205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619

Mailing address

409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612

Other identifiers 1

IdentifierTypeStateIssuer
103145523MedicaidPA

Other names 1

  • Elizabeth Ann Wentzel Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebross7144@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20070509000646 PA Practitioner - Physician Assistant 3274639141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Cardiovascular Institute IncGroup PAC ID 6901087006, 117 clinicians

Practice addresses (Care Compare)

111 S Front St
FL 2
Harrisburg, PA 17101-2010
Phone (717) 731-0101

360 Alexander Spring Rd
Carlisle, PA 17015-9129
Phone (717) 243-6557

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Merit-based Incentive Payment System (MIPS)

Final score
82.6 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA052909PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince May 1, 2012 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 1, 2012 Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

205 S Front St
Fl 4
Harrisburg, PA 17104
Phone (717) 231-8555

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

Interoperability endpoints

  • Direct secure messaging: ebross282756@upmc.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1811030802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "address_2": "4TH FLOOR, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103145523",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebross7144@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "205 S Front St",
            "address_2": "4th Floor, BMA",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171041619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WENTZEL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.