Constance Blaine Grau, DO
Individual provider Active NPI Family Medicine Physician · Casper, WY
NPI 1346503448 · NPPES record last updated Mar 30, 2020
Key facts
- NPI
- 1346503448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9914A (WY)
- Practice address
- 1522 E a St
Casper, WY 82601-2217 - Phone
- (307) 234-6161
- Fax
- (307) 234-7032
- NPI assigned
- Jun 22, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Wyoming
Practice addresses (Care Compare)
1522 E a St
Casper, WY 82601-2217
Phone (307) 431-5055
820 E 17TH St
Cheyenne, WY 82001-4714
Phone (307) 431-5055
Hospital & facility affiliations
- Banner Wyoming Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200410000861 | WY | Practitioner - Family Practice | 5395969505 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9914A | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wyoming | Family Medicine | Current |
Accepting new patients |
| University of Wyoming | Family Medicine | Past | Accepting new patients |
| Wyoming Medical Center Inc | Past | Accepting new patients |
Locations
1522 E A St
Casper, WY 82601
Phone (307) 233-6000
820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055
2710 Harney St
Ste 202
Laramie, WY 82072
Phone (307) 742-3242
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/
- constance.levy-grau.1@30244.direct.athenahealth.com
- blaine.levy@direct.wyomingmedicalcenter.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9914A | WY | Yes |
Addresses
Primary practice location
1522 E a St
Casper, WY 82601-2217
Mailing address
1522 E a St
Casper, WY 82601-2217
Phone (417) 354-1500
Other names
- Dr. Constance Blaine Levy
Other providers in Casper, WY
- Rachel Graham
- Ruthanne Grajeda
- Grand Teton Healing Center Inc
- Diana M Graney
- Michael J. Granum
- Venese Ann Graunke
- Desiree Kandra Gray-Mefferd
- Jenadene Gray
- Larissa Faith Gray
- Mariah Grayson
All providers in Casper, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.