Erica Leigh Costello, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA853 Issued in WY

Practice address

5840 E 2ND St Ste 200
Casper, WY 82609-4363

Phone

(307) 316-6133

Fax

(307) 315-6134

NPI assigned

Apr 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Leigh Carpenter Former name

Medicare fee-for-service enrollment

Enrolled in CA, WY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Family Medicine, LLCGroup PAC ID 6800941022, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012
• Summit Medical Center Hospital, Casper, WY, CCN 530034

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: erica.costello.1@20070.direct.athenahealth.com

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.

• Rocky Mountain Family Medicine LLC

  • Primary Care Clinic/Center
  • Casper, WY
  • NPI 1164650719
  Medicare reassignment Care Compare group
• University of Wyoming

  dba University of Wyoming Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Cheyenne, WY
  • NPI 1770681439
  Medicare reassignment
• Northeastern Rural Health Clinics

  • Family Medicine Physician
  • Susanville, CA
  • NPI 1477563518
  Medicare reassignment
• University of Wyoming

  dba Albany Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
  • NPI 1639617061
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Summit Medical Center, LLC

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1609297506
  Care Compare affiliation
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954
  Care Compare affiliation

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1760989859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094363",
            "telephone_number": "307-315-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094363",
            "telephone_number": "307-316-6133",
            "fax_number": "307-315-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "ERICA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA853",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "CARPENTER",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Nicole Cosner, LCSW
• Karri Cossabone
• Kimberly Cossin, LPC
• Judy Ann Costalez, RN
• Jeri Costel
• Malary Maude Cotnoir, PA
• Rachel Meredith Coto
• Deidra Cottenoir, PT
• Hannah Roberta Couldridge, BSW, CSW
• Christian Daniel Coulter

• Medical Physician Assistant in Casper, WY
• Providers in Casper, WY by specialty
• Medical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.