Individual provider Active NPI

Victoria A Cosgrove, PA-C

  • Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1437547692
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057479 Issued in PA
Practice address
100 E Lancaster Ave Ste 275
Wynnewood, PA 19096-3450
Phone
(484) 572-0171
Fax
(484) 476-1395
NPI assigned
Dec 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 MA057479 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 275
Wynnewood, PA 19096-3450

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Other practice location 1

6th Avenue and Spruce Street
West Reading, PA 19611-1428
Phone (484) 628-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150310000670 PA Practitioner - Physician Assistant 4880910827 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057479PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital CurrentSince Jan 26, 2015 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Reading Hospital CurrentSince Jan 26, 2015 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 7

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": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1437547692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 275",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-572-0171",
            "fax_number": "484-476-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6th Avenue and Spruce Street",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196111428",
            "country_code": "US",
            "telephone_number": "484-628-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSGROVE",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.