Individual provider Active NPI

Elizabeth Anne Gates, PHD

  • Psychologist
  • Platteville, WI
National Provider Identifier
1992726129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2438057 Issued in WI
Practice address
1250 Hwy 151 E
Ste D
Platteville, WI 53818
Phone
(608) 348-4060
Fax
(608) 348-4191
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2438057 WI Primary

Addresses

Primary practice location

1250 Hwy 151 E
Ste D
Platteville, WI 53818

Mailing address

1250 Hwy 151 E
Ste D
Platteville, WI 53818
Phone (608) 348-4060

Other identifiers 1

IdentifierTypeStateIssuer
43584100MedicaidWI

Other names 1

  • Elizabeth Anne Dew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731003933 WI Practitioner - Clinical Psychologist 3577899350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Iowa, RJ & L Carver College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platteville Family Resource Center IncGroup PAC ID 0042295016, 7 clinicians

Practice addresses (Care Compare)

1075 N Elm St
Platteville, WI 53818-1205
Phone (608) 348-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2438057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Platteville Family Resource Center Inc CurrentSince Jun 20, 2019 Accepting new patients
Platteville Family Resource Center Past Accepting new patients

Locations

1250 E Business Highway 151
Ste D
Platteville, WI 53818
Phone (608) 470-2200

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992726129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HWY 151 E",
            "address_2": "STE D",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "53818",
            "telephone_number": "608-348-4060",
            "fax_number": "608-348-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HWY 151 E",
            "address_2": "STE D",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "53818",
            "telephone_number": "608-348-4060",
            "fax_number": "608-348-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2438057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43584100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DEW",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Platteville, WI

Sources for this page

Verify at the official NPI Registry.