Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alexa Marie Datko, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1952047763

Alexa Marie Datko, MD is a Family Practice in Casper, Wyoming. Qualified in 2021, 5 years ago. Practices with Gracelight Community Health, a 25-clinician group and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
5
Licensed in
WY
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1522 E A St
Casper, WY 82601-2221
Phone: (307) 234-6161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 199-T1 (WY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1952047763
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 5, 2022
Last updated in NPPESJune 13, 2022
Certification dateJune 13, 2022
Mailing address1522 E A St, Casper, WY 82601-2221

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Gracelight Community Health — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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