Individual provider Active NPI

Amanda Lauren Costanzo, PA-C

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1043776941
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
023283 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-7300
NPI assigned
Feb 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 023283 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

3 Jackson Ter
Freehold, NJ 07728-2213

Other practice location 1

630 W 168th St
New York, NY 10032-3725
Phone (212) 305-2862

Other practice location 2

222 E 41st St Fl 12
New York, NY 10017-6739
Phone (646) 825-6300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acostanzo430974@nyumc.direct-ci.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230419001449 NY Practitioner - Physician Assistant 5890160162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023283NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Mar 1, 2023 Accepting new patients
New York University CurrentSince Mar 1, 2023 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

222 E 41st St
Fl 12
New York, NY 10017
Phone (646) 825-6300

Networks

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

Interoperability endpoints

  • Direct secure messaging: acostanzo430974@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1043776941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 JACKSON TER",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323725",
            "country_code": "US",
            "telephone_number": "212-305-2862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 E 41st St Fl 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176739",
            "country_code": "US",
            "telephone_number": "646-825-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "AMANDA",
        "middle_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acostanzo430974@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 E 41st St Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100176739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.