Active NPI
Sandra C Dacosta, CPNP
- Nurse Practitioner
- New Bedford, MA
National Provider Identifier
1023003688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 252152
- Practice address
- 225 Field St
New Bedford, MA 02740-2134 - Phone
- (508) 910-3371
- Fax
- (508) 910-3363
- NPI assigned
- Sep 20, 2005
- Last updated
- Mar 7, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 252152 | MA | Primary |
Addresses
Primary practice location
225 Field St
New Bedford, MA 02740-2134
Mailing address
225 Field St
New Bedford, MA 02740-2134
Phone (508) 910-3371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0703567 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
Interoperability endpoints
- sdacosta8086@direct.chppoc.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1023003688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 FIELD ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402134",
"telephone_number": "508-910-3371",
"fax_number": "508-910-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 FIELD ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027402134",
"telephone_number": "508-910-3371",
"fax_number": "508-910-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DACOSTA",
"first_name": "SANDRA",
"middle_name": "C",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-20",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "252152",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0703567",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.