Elizabeth Anne Sheppard, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105602 Issued in FL

Practice address

8725 N Wickham Rd Ste 202
Melbourne, FL 32940-2240

Phone

(321) 434-9528

Fax

(321) 434-9529

NPI assigned

Dec 13, 2010

Last updated

May 14, 2021By 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 1

Addresses

Other identifiers 3

Other names 1

• Elizabeth Anne Balcer Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Merit-based Incentive Payment System (MIPS)

Final score

94.79 of 100Reported as apm

Quality

86.5

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Griffith Urology, PLLC

  • Urology Physician
  • Melbourne, FL
  • NPI 1306545751
  Medicare reassignment
• Urologic Specialists of Central Florida PLLC

  • Urology Physician
  • Cocoa, FL
  • NPI 1710442264
  Medicare reassignment
• Osler Hma Medical Group LLC

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1518259050

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1891098943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 N WICKHAM RD STE 202",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402240",
            "telephone_number": "321-434-9528",
            "fax_number": "321-434-9529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 S Wickham Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "West Melbourne",
            "state": "FL",
            "postal_code": "329041170",
            "country_code": "US",
            "telephone_number": "321-727-8940",
            "fax_number": "321-733-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9105602",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "NR566",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BALCER",
            "middle_name": "ANNE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Denise Shepherd, DOULA
• Ryan Shepherd
• Susan Shepherd, ARNP
• Shepherd's Heart Ministries (The Transformation Center)
• Charles Nathaniel Sheppard, PT
• Stephen Ashley Sherbin Sr., HAS, BC-HIS
• Sheridan Healthcorp Inc
• Sheridan Healthcorp Inc
• Sheridan Healthcorp, Inc.
• Sheridan Surgery Center

• Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.