Active NPI
Dominic Acosta, PHARMD
- Infectious Diseases Pharmacist
- Henderson, NV
National Provider Identifier
1003661695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Diseases Pharmacist
- License
- 23812
- Practice address
- 3001 Saint Rose Pkwy
Henderson, NV 89052-3839 - Phone
- (702) 616-5000
- NPI assigned
- Apr 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Diseases Pharmacist | 1835I0206X | 23812 | NV | Primary |
Addresses
Primary practice location
3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Mailing address
1350 Kelso Dunes Ave Apt 721
Henderson, NV 89014-7849
Phone (505) 730-4474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23812 | NV | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1003661695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 KELSO DUNES AVE APT 721",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890147849",
"telephone_number": "505-730-4474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 SAINT ROSE PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523839",
"telephone_number": "702-616-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOSTA",
"first_name": "DOMINIC",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1835I0206X",
"taxonomy_group": "",
"desc": "Pharmacist, Infectious Diseases",
"state": "NV",
"license": "23812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.