Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elizabeth Mahoney, PA

Individual provider Physician Assistant · NPI 1417610890

Elizabeth Mahoney, PA is a Physician Assistant in Provo, Utah. Graduated from Pennsylvania State University College of Medicine in 2021, 5 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
5
Trained at
Pennsylvania State University College of Medicine
Licensed in
UT
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1055 N 500 W # 205
Provo, UT 84604-3305
Phone: (801) 429-8095
Fax: (801) 354-8265
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12474207-1206 (UT)

Record details

NPI number1417610890
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 21, 2021
Last updated in NPPESJanuary 31, 2022
Certification dateJanuary 31, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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