Individual provider Active NPI

Cassidy R Drevlow, DPT

  • Physical Therapist
  • Gillette, WY
National Provider Identifier
1023736089
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2196 Issued in WY
Practice address
1013 E Boxelder Rd Ste 100
Gillette, WY 82718-5936
Phone
(307) 682-4900
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2196 WY Primary

Addresses

Primary practice location

1013 E Boxelder Rd Ste 100
Gillette, WY 82718-5936

Mailing address

2600 Dallas Pkwy Ste 290
Frisco, TX 75034-7493
Phone (945) 260-0010

Other names 1

  • Cassidy R Koski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001502 WY Practitioner - Physical Therapist in Private Practice 2860869955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gillette Physical Therapy PCGroup PAC ID 0345282570, 10 clinicians

Practice addresses (Care Compare)

1013 E Boxelder Rd
Gillette, WY 82718-5923
Phone (307) 682-4900

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Physical Therapy PC Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Casper Orthopaedic Associates PC Physical Therapist PastSince Aug 28, 2022 Accepting new patients

Locations

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

1013 E Boxelder Rd
Ste 100
Gillette, WY 82718
Phone (307) 682-4900

1013 E Boxelder Rd
Gillette, WY 82718
Phone (307) 682-4900

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": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1023736089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "945-260-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 E BOXELDER RD STE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185936",
            "telephone_number": "307-682-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREVLOW",
        "first_name": "CASSIDY",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-2196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "KOSKI",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.