Elisa Bergquist, NP
Individual provider Active NPI Family Nurse Practitioner · La Porte, IN
NPI 1922476878 · NPPES record last updated Sep 18, 2020
Key facts
- NPI
- 1922476878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71005757A (IN)
- Practice address
- 500 Legacy PLZ W
La Porte, IN 46350-5254 - Phone
- (219) 326-0943
- Fax
- (219) 326-5684
- NPI assigned
- Sep 9, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2023 through Apr 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71005757A | IN | MD | Family Nurse Practitioner |
Interoperability endpoints
- elisa.berguist@laportehosp.cernerdirect.com
- elisa.bergquist@laportehosp.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71005757A | IN | Yes |
Addresses
Primary practice location
500 Legacy PLZ W
La Porte, IN 46350-5254
Mailing address
401 Newporte Blvd
La Porte, IN 46350-2479
Phone (219) 575-6244
Other names
- Elisa Lawson
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Elisa.Bergquist@laportehosp.cernerdirect.com | ||
| Direct Messaging Address | ELISA.BERGUIST@LAPORTEHOSP.CERNERDIRECT.COM | Direct |
Other providers in La Porte, IN
- Jenna Bellis
- Victor H Benavides Martinez
- Izabella Bensing
- Amanda Benson
- Brittni Diane Berger
- Brittany Betz
- Heidi Marie Bickel
- Kaitlin Ann Bildhauser
- April Lee Bisaga
- Caroline E Bjonback
All providers in La Porte, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2020. 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).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.