Individual provider Active NPI

Erin R Cottengim, P.A.-C

  • Family Medicine Physician
  • Maitland, FL
National Provider Identifier
1518263318
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA9105262 Issued in FL
Practice address
557 N Wymore Rd Ste 202
Maitland, FL 32751-4200
Phone
(407) 855-1073
Fax
(407) 218-4747
NPI assigned
Jan 27, 2011
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA9105262 FL Primary

Addresses

Primary practice location

557 N Wymore Rd Ste 202
Maitland, FL 32751-4200

Mailing address

PO Box 940973
Maitland, FL 32794-0973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140106001099 FL Practitioner - Physician Assistant 7416185061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Volusia Family and Sports Medicine IncGroup PAC ID 1456483098, 11 clinicians

Practice addresses (Care Compare)

1590 S Sr
15A Suite 100
Deland, FL 32720-7817
Phone (386) 774-0016

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Volusia Family and Sports Medicine Inc Family Medicine CurrentSince Nov 1, 2025 Accepting new patients
Town Center Family Practice Inc PastSince Apr 16, 2023 Accepting new patients
Florida Health Care Plan, Inc Past Accepting new patients

Locations

1590 S State Road 15A
#100
Deland, FL 32720
Phone (386) 774-0016

1590 S State Road 15A
Ste 100
Deland, FL 32720
Phone (386) 774-0016

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJGIBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIBCAA

Organizations & group practices 3

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 5

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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1518263318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940973",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327940973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 N WYMORE RD STE 202",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514200",
            "telephone_number": "407-855-1073",
            "fax_number": "407-218-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTENGIM",
        "first_name": "ERIN",
        "middle_name": "R",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9105262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.