NPIMap

Individual provider Active NPI

Molly M D'Costa, D.O.

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1033199369
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036116813 Issued in IL
Practice address
2710 111TH Street
Naperville, IL 60565-1189
Phone
(630) 355-9531
Fax
(630) 355-9532
NPI assigned
Jan 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3463 IA
Family Medicine Physician 207Q00000X 036116813 IL Primary

Addresses

Primary practice location

2710 111TH Street
Naperville, IL 60565-1189

Mailing address

911 N Elm St
Suite 215
Hinsdale, IL 60521-3634
Phone (630) 856-6820

Other identifiers 4

IdentifierTypeStateIssuer
2271700MedicaidIA
1271700MedicaidIA
3271700MedicaidIA
4271700MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061130000203 IL Practitioner - Family Practice 8921097395 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 Essington Rd
Joliet, IL 60435-1629
Phone (815) 733-6888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036116813ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Hospital CurrentSince May 1, 2008 Accepting new patients
Edward Health Ventures Family Medicine CurrentSince Feb 20, 2010 Accepting new patients
Edward Hospital CurrentSince May 1, 2008 Accepting new patients
Edward Health Ventures CurrentSince Feb 20, 2010 Accepting new patients
Adventist Health Partners,Inc Family Medicine Past Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients

Locations

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

Interoperability endpoints

  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

Organizations & group practices 7

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

Hospital & facility affiliations 6

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033199369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N ELM ST",
            "address_2": "SUITE 215",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213634",
            "telephone_number": "630-856-6820",
            "fax_number": "630-856-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 111TH STREET",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651189",
            "telephone_number": "630-355-9531",
            "fax_number": "630-355-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'COSTA",
        "first_name": "MOLLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3463",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036116813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2271700",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1271700",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3271700",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4271700",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.