Elizabeth L. Bailey, P.A.
Individual provider Active NPI Physician Assistant · Beloit, WI
NPI 1992196729 · NPPES record last updated Oct 6, 2016
Key facts
- NPI
- 1992196729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 3748-23 (WI)
- Practice address
- 1905 E Huebbe Pkwy
Beloit Health System Inc.
Beloit, WI 53511-1842 - Phone
- (608) 364-2200
- Fax
- (608) 363-7374
- NPI assigned
- Feb 16, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Swedishamerican Hospital
Practice addresses (Care Compare)
1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400
209 9TH St
Suite 200
Rockford, IL 61104-2235
Phone (779) 696-2750
6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610
Hospital & facility affiliations
- Uw Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.51 of 100
- Quality
- 83.2
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 71.7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, WI
- 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 |
|---|---|---|---|---|
| I20150514002719 | IL | Practitioner - Physician Assistant | 7517287550 | Reassigns benefits to 1 organization |
| I20160804001772 | WI | Practitioner - Physician Assistant | 7517287550 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.005081 | IL | MD | Physician Assistant |
| 3748-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beloit Clinic, S.C. | Current | Accepting new patients | |
| Swedishamerican Hospital | Current |
Accepting new patients | |
| Swedishamerican Hospital | Current |
Accepting new patients | |
| Beloit Health System, Inc | Current |
Accepting new patients | |
| Beloit Health System Inc | Current |
Accepting new patients |
Locations
1401 E State St
Rockford, IL 61104
Phone (815) 489-4267
6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610
1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293
1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510
1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.005081 | IL | |
| Physician Assistant | 363A00000X | 3748-23 | WI | Yes |
Addresses
Primary practice location
1905 E Huebbe Pkwy
Beloit Health System Inc.
Beloit, WI 53511-1842
Mailing address
1905 E Huebbe Pkwy
Beloit Health System Inc.
Beloit, WI 53511-1842
Phone (414) 290-6720
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100043748 | Medicaid | WI |
NPI Registry JSON
{
"created_epoch": "1424044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1992196729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 E HUEBBE PKWY",
"address_2": "BELOIT HEALTH SYSTEM INC.",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "414-290-6720",
"fax_number": "414-290-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 E HUEBBE PKWY",
"address_2": "BELOIT HEALTH SYSTEM INC.",
"city": "BELOIT",
"state": "WI",
"postal_code": "535111842",
"telephone_number": "608-364-2200",
"fax_number": "608-363-7374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "ELIZABETH",
"middle_name": "L.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-16",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.005081",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3748-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100043748",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beloit, WI
- Aurora Pharmacy Inc
- Az Tech Radiology and Open MRI LLC
- Michelle Babilius
- Suzanne Marie Baer
- Lisa Lynn Bagniefski
- Kelly Bailey
- Patrick S Bailey
- Leora Baremore
- Kristen Elizabeth Barger
- Sabry Barreras
All providers in Beloit, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2016. 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.