Active NPI
Alyssa Dawn Zantello, PA-C
- Physician Assistant
- Cody, WY
National Provider Identifier
1780032524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1004
- Practice address
- 424 Yellowstone Ave Ste 120
Cody, WY 82414-9311 - Phone
- (307) 578-2903
- Fax
- (307) 578-2937
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007768 | MI | |
| Physician Assistant | 363A00000X | PA1004 | WY | Primary |
Addresses
Primary practice location
424 Yellowstone Ave Ste 120
Cody, WY 82414-9311
Mailing address
707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 578-2000
Other practice location 1
4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546-8292
Phone (616) 267-8860
Other practice location 2
707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 578-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216670400 | Medicaid | WY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
424 Yellowstone Ave
Cody, WY 82414-9309
Phone (307) 527-7501
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.79 of 100
- Quality
- 72.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 63.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Park Hospital District | Current | Accepting new patients | |
| Cody Regional Health EMS | Current | Accepting new patients | |
| West Park Hospital District | Current | Accepting new patients | |
| Advanced Orthopedic Specialists PC | Past | Accepting new patients |
Locations
707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561
424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903
Organizations & group practices 5
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.
-
dba Cody Regional Health
- Critical Access Hospital
- Cody, WY
- NPI 1558351536
-
- Land Ambulance
- Cody, WY
- NPI 1366432197
-
- Multi-Specialty Clinic/Center
- Cody, WY
- NPI 1477192243
-
- Emergency Medicine Physician
- Basin, WY
- NPI 1942921937
-
- Non-Pharmacy Dispensing Site
- Brighton, MI
- NPI 1053625467
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Cody Regional Health
- Critical Access Hospital
- Cody, WY
- NPI 1558351536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1780032524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SHERIDAN AVE",
"city": "CODY",
"state": "WY",
"postal_code": "824143409",
"telephone_number": "307-578-2000",
"fax_number": "307-578-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 YELLOWSTONE AVE STE 120",
"city": "CODY",
"state": "WY",
"postal_code": "824149311",
"telephone_number": "307-578-2903",
"fax_number": "307-578-2937"
}
],
"practiceLocations": [
{
"address_1": "4100 Lake Dr SE Ste 300",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495468292",
"country_code": "US",
"telephone_number": "616-267-8860",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "707 Sheridan Ave",
"address_purpose": "LOCATION",
"city": "Cody",
"state": "WY",
"postal_code": "824143409",
"country_code": "US",
"telephone_number": "307-578-2000",
"fax_number": "307-578-2010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZANTELLO",
"first_name": "ALYSSA",
"middle_name": "DAWN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601007768",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WY",
"license": "PA1004",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "216670400",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cody, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.