Individual provider Active NPI

Caitlin Elizabeth Colosky, PA-C

  • Medical Physician Assistant
  • Bedford, TX
National Provider Identifier
1629439476
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5934
Phone
(817) 684-5106
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TX Primary

Addresses

Primary practice location

1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5934

Mailing address

5829 Goliad Ave
Dallas, TX 75206-6817
Phone (817) 602-6302

Other names 1

  • Caitlin Elizabeth Baran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160726000102 TX Practitioner - Physician Assistant 6901199140 Reassigns benefits to 1 organization

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
Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

12469 Timberland Blvd
Suite 501
Fort Worth, TX 76244-5216
Phone (817) 431-6555

1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5936
Phone (817) 984-5100

7106 New Sanger Rd
Waco, TX 76712-3928
Phone (254) 537-1265

Merit-based Incentive Payment System (MIPS)

Final score
83.97 of 100Reported as group
Quality
76.91
Promoting interoperability
91
Improvement activities
40
Cost
77.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
R Todd Plott MD PA CurrentSince Oct 30, 2011 Accepting new patients

Locations

12469 Timberland Blvd
Ste 501
Fort Worth, TX 76244
Phone (817) 431-6555

Interoperability endpoints

  • Direct secure messaging: caitlin.colosky@epiphanyderm.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1629439476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5829 GOLIAD AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066817",
            "telephone_number": "817-602-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY",
            "address_2": "SUITE 306",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225934",
            "telephone_number": "817-684-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOSKY",
        "first_name": "CAITLIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "BARAN",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.