Individual provider Active NPI

Bryant Anthony Acosta, PA-C

  • Medical Physician Assistant
  • Winnfield, LA
National Provider Identifier
1952445249
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.A10303.RX Issued in LA
Practice address
609 W Court St Ste B
Winnfield, LA 71483-2686
Phone
(318) 209-4646
Fax
(318) 209-4649
NPI assigned
Feb 19, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.A10303.RX LA Primary
Paramedic 146L00000X PO835285 LA

Addresses

Primary practice location

609 W Court St Ste B
Winnfield, LA 71483-2686

Mailing address

431 W Lafayette St
Winnfield, LA 71483-3463
Phone (318) 648-0375

Other identifiers 1

IdentifierTypeStateIssuer
1452602MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041201000682 LA Practitioner - Physician Assistant 8921063991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CLHG-Winn, LLCGroup PAC ID 6002198736, 17 clinicians

Practice addresses (Care Compare)

301 W Boundary Ave
Winn Parish Medical Center Physica
Winnfield, LA 71483-3427
Phone (318) 648-3000

301 W Boundary Ave B
Winn Wellness Clinic
Winnfield, LA 71483-3427
Phone (318) 209-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PO835285LAMDParamedic
PA.A10303.RXLAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Winn LLC CurrentSince Jun 20, 2019 Accepting new patients
CLHG-Winn, LLC CurrentSince Jun 20, 2019 Accepting new patients

Locations

301 W Boundary Ave
Winnfield, LA 71483
Phone (318) 628-2721

301 W Boundary Ave
Ste B
Winnfield, LA 71483
Phone (318) 209-4646

609 W Court St
Ste B
Winnfield, LA 71483
Phone (318) 209-4646

639 W Lafayette St
Winnfield, LA 71483
Phone (318) 648-2220

Interoperability endpoints

  • Direct secure messaging: bryant.acosta.2@25133.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952445249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W LAFAYETTE ST",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714833463",
            "telephone_number": "318-648-0375",
            "fax_number": "318-648-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W COURT ST STE B",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714832686",
            "telephone_number": "318-209-4646",
            "fax_number": "318-209-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "BRYANT",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.A10303.RX",
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "LA",
            "license": "PO835285",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452602",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnfield, LA

Sources for this page

Verify at the official NPI Registry.