Individual provider Active NPI

Anna K. Costakis, M.D.

  • Psychiatry Physician
  • Glen Oaks, NY
National Provider Identifier
1023224870
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
267575 Issued in NY
Practice address
7559 263Rd St # 200
Glen Oaks, NY 11004
Phone
(718) 470-8080
Fax
(718) 831-0368
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036119122 IL
Psychiatry Physician 2084P0800X 267575 NY Primary

Addresses

Primary practice location

7559 263Rd St # 200
Glen Oaks, NY 11004

Mailing address

7559 263Rd St # 200
Glen Oaks, NY 11004-1150
Phone (718) 470-8080

Other practice location 1

411 W. 114th St.
New York, NY 10025
Phone (212) 523-2906

Other practice location 2

411 W. 114th St.
New York, NY 10025
Phone (212) 523-2906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000312 NY Practitioner - Psychiatry 4082767124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036119122ILMDPsychiatry Physician

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Aug 23, 2023 Accepting new patients
Families and Individuals in Recovery CurrentSince Jun 9, 2020 Accepting new patients
Metropolitan Center for Mental Health, Inc. CurrentSince Jun 9, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 23, 2023 Accepting new patients
Staten Island University Hospital Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
#200
Glen Oaks, NY 11004
Phone (718) 470-8080

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: acostakis29020@northwell.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1023224870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7559 263RD ST # 200",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150",
            "telephone_number": "718-470-8080",
            "fax_number": "718-831-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 263RD ST # 200",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "11004",
            "telephone_number": "718-470-8080",
            "fax_number": "718-831-0368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 W. 114th St.",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10025",
            "country_code": "US",
            "telephone_number": "212-523-2906",
            "fax_number": "212-523-4069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 W. 114th St.",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10025",
            "country_code": "US",
            "telephone_number": "212-523-2906",
            "fax_number": "212-523-4069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTAKIS",
        "first_name": "ANNA",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036119122",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "267575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.