Elizabeth A Divyak, PA-C is a
Physician Assistant based in Madison, Wisconsin. Elizabeth A Divyak is licensed to practice in Wisconsin (license number 5122-23) and her current practice location is
700 S Park St, Madison, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(608) 251-6100.
NPI number for Elizabeth A Divyak is 1174710560 and her current mailing address is 700 S Park St, Madison, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174710560.
Healthcare Provider's Profile
Full Name | Elizabeth A Divyak |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 700 S Park St, Madison, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1174710560
- Provider Enumeration Date: 09/28/2007
- Last Update Date: 01/18/2021
Medical Identifiers
Medical identifiers for Elizabeth A Divyak such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174710560 | NPI | - | NPPES |
1174710560 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
235Z00000X | Speech-language Pathologist | 3013-154 (Wisconsin) | Secondary |
363A00000X | Physician Assistant | 5122-23 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elizabeth A Divyak is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Elizabeth A Divyak, PA-C 700 S Park St, Madison, WI 53715-1830 Ph: (608) 251-6100 | Elizabeth A Divyak, PA-C 700 S Park St, Madison, WI 53715-1830 Ph: (608) 251-6100 |
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