NPIMap

Individual provider Active NPI

Elizabeth E Anderson, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1922077445
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1176 Issued in 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
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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 073000 IA
Physician Assistant 363A00000X 1176 NE Primary

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 names 1

  • Elizabeth E Menousek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000358 NE Practitioner - Physician Assistant 1052363264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1176NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eanderson46784@achce.catholichealth.net

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

Hospital & facility affiliations 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1922077445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-5880",
            "fax_number": "402-398-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304664",
            "telephone_number": "402-398-5880",
            "fax_number": "402-398-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "073000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MENOUSEK",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.