NPI 1083390736 · live from the CMS NPI Registry
Megan Kristine Acosta O'Gara
Physician Assistant in Pueblo, CO. National Provider Identifier 1083390736, active.
NPI record
| NPI | 1083390736 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4722 Eagleridge Cir, Pueblo, CO 81008 |
| Practice phone | 719-595-7563 |
| Enumerated | June 27, 2023 |
| Last updated | February 4, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant primary | 363A00000X | PA.0009026 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.