Individual provider Active NPI

Elizabeth Mary Dauer, PA-C

  • Physician Assistant
  • West Orange, NJ
National Provider Identifier
1841775236
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00766900 Issued in NJ
Practice address
101 Old Short Hills Rd Ste 217
West Orange, NJ 07052-1091
Phone
(973) 731-4600
NPI assigned
Oct 1, 2018
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 25MP00766900 NJ Primary
Internal Medicine Physician 207R00000X 022690 NY

Addresses

Primary practice location

101 Old Short Hills Rd Ste 217
West Orange, NJ 07052-1091

Mailing address

564 1St St Apt 3
Hoboken, NJ 07030-6541
Phone (973) 600-1085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241018001908 NJ Practitioner - Physician Assistant 5395277057 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00766900NJMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1841775236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 1ST ST APT 3",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306541",
            "telephone_number": "973-600-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD STE 217",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521091",
            "telephone_number": "973-731-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUER",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00766900",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "022690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.