Individual provider Active NPI

Elizabeth G Diaz, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1891147542
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4828-23 Issued in WI
Practice address
301 S Westfield Rd Ste 120
Madison, WI 53717-1729
Phone
(608) 282-8050
NPI assigned
Jul 6, 2016
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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 4828-23 WI Primary

Addresses

Primary practice location

301 S Westfield Rd Ste 120
Madison, WI 53717-1729

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

700 S Park St Ste A
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1891147542MedicaidWI

Other names 1

  • Elizabeth G Hartig Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ehartig260315@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180212002836 WI Practitioner - Physician Assistant 5991085268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 N Nine Mound Rd
Verona, WI 53593-1032
Phone (608) 287-2770

3209 Dryden Dr
Madison, WI 53704-3015
Phone (608) 287-2770

5565 Tancho Dr
Madison, WI 53718-1901
Phone (608) 230-4000

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

702 Jupiter Dr
Madison, WI 53718-2972
Phone (608) 251-1010

7102 Mineral Point Rd
Madison, WI 53717-1706
Phone (608) 828-7603

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4828-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 1, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 1, 2024 Accepting new patients
University of Wisconsin Medical Foundation Inc PastSince Mar 12, 2024 Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

700 S Park St
Ste A
Madison, WI 53715
Phone (608) 260-2900

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1891147542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WESTFIELD RD STE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171729",
            "telephone_number": "608-282-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St Ste A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ELIZABETH",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4828-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891147542",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehartig260315@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ehartig260315@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HARTIG",
            "middle_name": "G",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.