Individual provider Active NPI

Erena Hintsa, PA-C

  • Physician Assistant
  • Laramie, WY
National Provider Identifier
1003393984
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PT775 Issued in WY
Practice address
1909 Vista Dr
Laramie, WY 82070-5599
Phone
(307) 745-8851
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PT775 WY Primary

Addresses

Primary practice location

1909 Vista Dr
Laramie, WY 82070-5599

Mailing address

1909 Vista Dr
Laramie, WY 82070-5599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220725000654 TX Practitioner - Physician Assistant 3577814250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

11350 US Hwy 380
Suite 100
Cross Roads, TX 76227-8319
Phone (940) 228-0721

1559 W Main St
Lewisville, TX 75067-3394
Phone (972) 436-0333

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

4524 W Bailey Boswell Rd
Fort Worth, TX 76179-4319
Phone (817) 720-9685

5301 William D Tate Ave
Suite 100
Grapevine, TX 76051-7357
Phone (817) 251-2101

5405 S Cooper St
Arlington, TX 76017-6148
Phone (817) 465-4928

7232 N Fwy
Fort Worth, TX 76137-2481
Phone (817) 439-8100

8901 N Fwy 111
Fort Worth, TX 76177-7655
Phone (469) 778-5228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Primary Care CurrentSince Sep 1, 2020 Accepting new patients
Summit Primary Care CurrentSince Sep 1, 2020 Accepting new patients
Summit Primary Care PastSince May 1, 2020 Accepting new patients

Locations

75 Printers Pkwy
Ste 200
Colorado Springs, CO 80910
Phone (719) 300-1122

300 E Hampden Ave
Ste 201
Englewood, CO 80113
Phone (303) 991-7700

Interoperability endpoints

  • Direct secure messaging: ehintsa@premierbonejc1834.srs-direct.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1003393984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705599",
            "telephone_number": "307-745-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTSA",
        "first_name": "ERENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PT775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.