Individual provider Active NPI

Sandra C Dacosta, CPNP

  • Nurse Practitioner
  • New Bedford, MA
National Provider Identifier
1023003688
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
252152 Issued in MA
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, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0703567MedicaidMA

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

  • Direct secure messaging: 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.

Verify at the official NPI Registry.