Individual provider Active NPI

Wesley Coleman

  • Physician Assistant
  • Alexandria, LA
National Provider Identifier
1124492137
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA300402 Issued in LA
Practice address
145 Yorktown Dr
Alexandria, LA 71303-3621
Phone
(318) 445-8380
Fax
(318) 445-9753
NPI assigned
Nov 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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 PA300402 LA Primary

Addresses

Primary practice location

145 Yorktown Dr
Alexandria, LA 71303-3621

Mailing address

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 445-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20151230001014 LA Practitioner - Physician Assistant 3870895303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Clinic LLCGroup PAC ID 4789668831, 29 clinicians

Practice addresses (Care Compare)

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 255-3690

1809 Northpointe LN
102 Quickcare of Ruston
Ruston, LA 71270-3852
Phone (318) 255-3762

Hospital & facility affiliations

  • Northern Louisiana Medical Center Hospital, Ruston, LA, CCN 190086

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Improvement activities
40
Cost
73.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA300402LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Green Clinic LLC CurrentSince Aug 10, 2019 Accepting new patients

Locations

1809 Northpointe Ln
Ste 102
Ruston, LA 71270
Phone (318) 255-3762

1200 S Farmerville St
Ruston, LA 71270
Phone (318) 251-6103

Interoperability endpoints

  • Direct secure messaging: wesley.coleman@gcqc.directbygreenway.com
  • Direct secure messaging: wesley.coleman.1@26990.direct.athenahealth.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1124492137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-445-8380",
            "fax_number": "318-445-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 YORKTOWN DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033621",
            "telephone_number": "318-445-8380",
            "fax_number": "318-445-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "WESLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA300402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.