Individual provider Active NPI

Andrea M Costanza, D.O.

  • Dermatology Physician
  • Hilliard, OH
National Provider Identifier
1033243175
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
34009330 Issued in OH
Practice address
3853 Trueman CT
Hilliard, OH 43026-2496
Phone
(614) 777-1200
Fax
(614) 777-1294
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 34009330 OH Primary

Addresses

Primary practice location

3853 Trueman CT
Hilliard, OH 43026-2496

Mailing address

3853 Trueman CT
Hilliard, OH 43026-2496
Phone (614) 777-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090616000722 OH Practitioner - Dermatology 1557462330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Maryland School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Dermatology LLCGroup PAC ID 7214086115, 8 clinicians

Practice addresses (Care Compare)

3853 Trueman CT
Hilliard, OH 43026-2496
Phone (614) 777-1200

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1077
Removal or shaving of skin growth1-10
Skin biopsy174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34009330OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Dermatology LLC Dermatology CurrentSince May 1, 2009 Accepting new patients
Worst Day Ever PastSince May 1, 2009 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3853 Trueman Ct
Hilliard, OH 43026
Phone (614) 777-1200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1033243175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3853 TRUEMAN CT",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430262496",
            "telephone_number": "614-777-1200",
            "fax_number": "614-777-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3853 TRUEMAN CT",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430262496",
            "telephone_number": "614-777-1200",
            "fax_number": "614-777-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZA",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "34009330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.