Active NPI
Elisa Denise Garrett, AGNP-C
- Gerontology Nurse Practitioner
- Lincoln City, OR
National Provider Identifier
1811550866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 201903457NP-PP
- Practice address
- 4488 NE Devils Lake Blvd
Lincoln City, OR 97367-5065 - Phone
- (541) 614-0407
- Fax
- (833) 973-5262
- NPI assigned
- Apr 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | AG03190056 | OR | |
| Gerontology Nurse Practitioner | 363LG0600X | 201903457NP-PP | OR | Primary |
Addresses
Primary practice location
4488 NE Devils Lake Blvd
Lincoln City, OR 97367-5065
Mailing address
PO Box 1193
Corvallis, OR 97339-1193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190627000491 | OR | Practitioner - Nurse Practitioner | 2668706599 | Practice locations: Lincoln City, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4488 NE Devils Lake Blvd
Lincoln City, OR 97367-5065
Phone (801) 201-6755
Hospital & facility affiliations
- Signature Healthcare at Home
- Samaritan North Lincoln Hospital
- Samaritan Pacific Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201903457NP-PP | OR | MD | Gerontology Nurse Practitioner |
| AG03190056 | OR | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Medical LLC | Gerontology | Current | Accepting new patients |
Locations
4488 NE Devils Lake Blvd
Lincoln City, OR 97367
Phone (541) 614-0407
Interoperability endpoints
- elisa.garrett.1@32213.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Gerontology Nurse Practitioner
- Lincoln City, OR
- NPI 1902615677
Hospital & facility affiliations 22
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Lincoln City, OR
- NPI 1306897491
-
- Hematology & Oncology Physician
- Lincoln City, OR
- NPI 1629338868
Hospital
-
- Cardiovascular Disease Physician
- Lincoln City, OR
- NPI 1841554177
Hospital
-
- Obstetrics & Gynecology Physician
- Newport, OR
- NPI 1669529087
Hospital
-
- Hospitalist Physician
- Newport, OR
- NPI 1811045867
-
- Rural Health Clinic/Center
- Newport, OR
- NPI 1831246248
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1811550866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1193",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4488 NE DEVILS LAKE BLVD",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "973675065",
"telephone_number": "541-614-0407",
"fax_number": "833-973-5262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRETT",
"first_name": "ELISA",
"middle_name": "DENISE",
"credential": "AGNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-16",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OR",
"license": "AG03190056",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OR",
"license": "201903457NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.