NPIMap

Individual provider Active NPI

Erica Ryan Dacosta, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1639121791
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05121 Issued in NC
Practice address
1225 Harding PL
Ste 5100
Charlotte, NC 28204-2826
Phone
(704) 355-8850
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 0010-05121 NC Primary

Addresses

Primary practice location

1225 Harding PL
Ste 5100
Charlotte, NC 28204-2826

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

16455 Statesville Rd
Ste 200
Huntersville, NC 28078-7135
Phone (704) 801-3011

Other practice location 2

10650 Park Rd
Ste 480
Charlotte, NC 28210-8538
Phone (704) 667-0520

Other practice location 3

10650 Park Rd
Ste 480
Charlotte, NC 28210-8538
Phone (704) 667-8860

Other practice location 4

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Phone (704) 355-4593

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address edacosta451773@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150218001401 NC Practitioner - Physician Assistant 7214005396 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrium Health Specialty Network IncGroup PAC ID 5193245801, 248 clinicians

Practice addresses (Care Compare)

1225 Harding PL
Charlotte, NC 28204-2826
Phone (704) 355-8850

4525 Cameron Valley Pkwy
Charlotte, NC 28211-4369
Phone (704) 468-8874

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05121NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 26, 2015 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 26, 2015 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 3, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 3, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 3, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1225 Harding Pl
Ste 5100
Charlotte, NC 28204
Phone (704) 355-8850

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

101 E Wt Harris Blvd
Ste 3301
Charlotte, NC 28262
Phone (704) 403-1308

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

10650 Park Rd
Ste 480
Charlotte, NC 28210
Phone (704) 355-1813

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

16455 Statesville Rd
Ste 200
Huntersville, NC 28078
Phone (704) 302-8600

Interoperability endpoints

  • Direct secure messaging: edacosta451773@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 10

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1639121791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HARDING PL",
            "address_2": "STE 5100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042826",
            "telephone_number": "704-355-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-801-3011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 480",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-0520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 480",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-4593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ERICA",
        "middle_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edacosta451773@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1225 Harding Pl",
            "address_2": "Ste 5100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.