Individual provider Active NPI

Elizabeth Walter, PA

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1912280918
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4920 Issued in AZ
Practice address
5056 N Central Ave
Phoenix, AZ 85012-1521
Phone
(602) 222-9111
Fax
(602) 222-9333
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4920 AZ Primary

Addresses

Primary practice location

5056 N Central Ave
Phoenix, AZ 85012-1521

Mailing address

5056 N Central Ave
Phoenix, AZ 85012-1521
Phone (602) 222-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20111220000001 AZ Practitioner - Physician Assistant 8820263908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Skin II PCGroup PAC ID 8123019833, 9 clinicians

Practice addresses (Care Compare)

5056 N Central Ave
Phoenix, AZ 85012-1521
Phone (602) 222-9111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Squaw Peak Anesthesia Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1912280918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5056 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121521",
            "telephone_number": "602-222-9111",
            "fax_number": "602-222-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5056 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121521",
            "telephone_number": "602-222-9111",
            "fax_number": "602-222-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.