Elizabeth E Anderson, PA-C
Individual provider Active NPI Physician Assistant · Omaha, NE
NPI 1922077445 · NPPES record last updated Dec 18, 2019
Key facts
- NPI
- 1922077445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1176 (NE)
- Practice address
- 16909 Lakeside Hills CT
Suite 101
Omaha, NE 68130-4664 - Phone
- (402) 398-5880
- Fax
- (402) 398-6716
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alegent Creighton Clinic
Practice addresses (Care Compare)
11111 S 84TH St
Papillion, NE 68046-4122
Phone (402) 898-2520
16909 Lakeside Hills CT
Omaha, NE 68130-4661
430 N Monitor St
West Point, NE 68788-1555
Phone (402) 372-2404
7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580
7710 Mercy Rd
Omaha, NE 68124-2323
Hospital & facility affiliations
- St Francis Memorial Hospital
- CHI Health Bergan Mercy
- CHI Health Lakeside
- CHI Health Midlands
- CHI Health Mercy Council Bluffs
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050216000358 | NE | Practitioner - Physician Assistant | 1052363264 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1176 | NE | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- eanderson46784@achce.catholichealth.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 073000 | IA | |
| Physician Assistant | 363A00000X | 1176 | NE | Yes |
Addresses
Primary practice location
16909 Lakeside Hills CT
Suite 101
Omaha, NE 68130-4664
Mailing address
7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-5880
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 098684468 | Other | NE | MEDICARE PTAN |
Other names
- Elizabeth E Menousek
Other providers in Omaha, NE
- Diana Anderson
- Diane Marie Anderson
- Dianne K Anderson
- Donald G. Anderson
- Dorothy J Anderson
- Elizabeth S Anderson
- Erik Darnell Anderson Sr.
- Gary Lee Anderson Jr.
- Gina Lynn Anderson
- Gwen Anderson
All providers in Omaha, NE · Physician Assistant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.