Active NPI
Elizabeth Kathleen Quadraccia, PA
- Physician Assistant
- San Mateo, CA
National Provider Identifier
1811936800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601006414
- Practice address
- 210 Baldwin Ave
San Mateo, CA 94401-3915 - Phone
- (650) 579-6581
- NPI assigned
- Jun 5, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-00390 | NC | |
| Physician Assistant | 363A00000X | 5601006414 | MI | Primary |
Addresses
Primary practice location
210 Baldwin Ave
San Mateo, CA 94401-3915
Mailing address
370 Golden Grass Dr Ste 400
Alamo, CA 94507-2789
Phone (650) 995-1515
Other names 1
- Elizabeth K Miller
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-00390 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Medical Group | Past | Accepting new patients |
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.
-
- Pain Medicine Physician
- Visalia, CA
- NPI 1326409343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1811936800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 GOLDEN GRASS DR STE 400",
"city": "ALAMO",
"state": "CA",
"postal_code": "945072789",
"telephone_number": "650-995-1515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 BALDWIN AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013915",
"telephone_number": "650-579-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUADRACCIA",
"first_name": "ELIZABETH",
"middle_name": "KATHLEEN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-00390",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601006414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "MILLER",
"middle_name": "K",
"credential": "PA",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.