Active NPI
Costa Fotopoulos, R.D., M.S., C.N.S.
- Nutritionist
- Brooklyn, NY
National Provider Identifier
1033157219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 000412-1
- Practice address
- 800 Poly PL
Brooklyn, NY 11209-7104 - Phone
- (718) 836-6600
- NPI assigned
- Jun 2, 2006
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 000412-1 | NY | Primary |
Addresses
Primary practice location
800 Poly PL
Brooklyn, NY 11209-7104
Mailing address
2726 Francis Lewis Blvd
Flushing, NY 11358-1147
Phone (718) 358-5765
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78P0031 | Other | NY | NYPCHP |
| P467422 | Other | NY | OXFORD HEALTH PLANS |
| 000412-1 | Other | NY | CERTIFIED NUTRITIONIST |
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 Nurse Specialist, Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1033157219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2726 FRANCIS LEWIS BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113581147",
"telephone_number": "718-358-5765",
"fax_number": "718-358-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "718-836-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOTOPOULOS",
"first_name": "COSTA",
"name_prefix": "Mr.",
"credential": "R.D., M.S., C.N.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "000412-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYPCHP",
"identifier": "78P0031",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "P467422",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED NUTRITIONIST",
"identifier": "000412-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.