Individual provider Active NPI

Elizabeth J. Nealy, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1962128736
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61304097 Issued in WA
Practice address
601 Broadway FL 7
Seattle, WA 98122-5330
Phone
(206) 386-2600
Fax
(206) 622-1644
NPI assigned
Oct 13, 2022
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 61304097 WA
Surgical Physician Assistant 363AS0400X PA61304097 WA Primary

Addresses

Primary practice location

601 Broadway FL 7
Seattle, WA 98122-5330

Mailing address

601 Broadway FL 7
Seattle, WA 98122-5330
Phone (206) 386-2600

Other practice location 1

3623 SW Alaska St
Seattle, WA 98126-2732
Phone (206) 386-2600

Other practice location 2

4455 148th Ave NE # B1
Bellevue, WA 98007-3120
Phone (206) 386-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20221202002357 WA Practitioner - Physician Assistant 2365811981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Opa Ortho PLLCGroup PAC ID 7012371305, 42 clinicians

Practice addresses (Care Compare)

601 Broadway
Suite 700
Seattle, WA 98122-5330
Phone (206) 622-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61304097WAMDPhysician Assistant
PA61304097WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S Surgical CurrentSince Nov 15, 2022 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Nov 15, 2022 Accepting new patients

Locations

3623 SW Alaska St
Seattle, WA 98126
Phone (206) 362-8674

601 Broadway
Seattle, WA 98122
Phone (206) 215-6415

601 Broadway
#700
Seattle, WA 98122
Phone (206) 622-2600

601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100

601 Broadway
Fl 7
Seattle, WA 98122
Phone (206) 518-6311

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: elizabeth.harper.p1@direct.opa.nextgenshare.com

Organizations & group practices 4

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1962128736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROADWAY FL 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225330",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY FL 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225330",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3623 SW Alaska St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981262732",
            "country_code": "US",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4455 148th Ave NE # B1",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073120",
            "country_code": "US",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEALY",
        "first_name": "ELIZABETH",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61304097",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61304097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.