Individual provider Active NPI

Christina Elize Aquino Jara, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Casper, WY
National Provider Identifier
1386199958
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
13022A Issued in WY
Practice address
1020 S Conwell St
Casper, WY 82601-3921
Phone
(307) 265-8300
Fax
(307) 233-8230
NPI assigned
Aug 23, 2016
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 13022A WY Primary

Addresses

Primary practice location

1020 S Conwell St
Casper, WY 82601-3921

Mailing address

570 Granite Peak Dr Apt 302
Casper, WY 82609-4533
Phone (201) 894-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200903003764 WY Practitioner - Internal MedicinePractitioner - Other (Physician) 8022436690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1020 S Conwell St
Casper, WY 82601-3921
Phone (307) 265-8300

1106 Big Horn Ave
Worland, WY 82401-2803
Phone (307) 347-8801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.9 of 100Reported as group
Quality
68.13
Promoting interoperability
99
Improvement activities
40
Cost
69.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians West LLC CurrentSince Nov 1, 2023 Accepting new patients
Banner Health Physicians West LLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

1020 S Conwell St
Casper, WY 82601
Phone (307) 265-3622

1106 Big Horn Ave
Worland, WY 82401
Phone (307) 347-3221

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1386199958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 GRANITE PEAK DR APT 302",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094533",
            "telephone_number": "201-894-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S CONWELL ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013921",
            "telephone_number": "307-265-8300",
            "fax_number": "307-233-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARA",
        "first_name": "CHRISTINA ELIZE",
        "middle_name": "AQUINO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WY",
            "license": "13022A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.