NPIMap

Individual provider Active NPI

Victor Costa, M.D.

  • Surgery Physician
  • Overland Park, KS
National Provider Identifier
1053707638
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA10462000 Issued in NJ
Practice address
5100 W 110TH St Ste 110
Overland Park, KS 66211-1215
Phone
(913) 345-6960
Fax
(913) 345-6966
NPI assigned
Apr 10, 2015
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA10462000 NJ Primary

Addresses

Primary practice location

5100 W 110TH St Ste 110
Overland Park, KS 66211-1215

Mailing address

5100 W 110TH St Ste 110
Overland Park, KS 66211-1215
Phone (913) 345-6960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230905000690 MO Practitioner - General Surgery 9335502699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1965 S Fremont Ave
100 MC General and Specialty Surgery
Springfield, MO 65804-2299
Phone (417) 820-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.24 of 100Reported as group
Quality
82.77
Promoting interoperability
99
Improvement activities
40
Cost
74.45

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux33
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10462000NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Midwest Heart & Vascular Specialists, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 320
Rolla, MO 65401
Phone (573) 458-6310

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

1965 S Fremont Ave
Ste 100
Springfield, MO 65804
Phone (417) 820-3800

1965 S Fremont Ave
Ste 230
Springfield, MO 65804
Phone (417) 820-7250

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Networks

  • IA HMO

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1053707638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W 110TH ST STE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111215",
            "telephone_number": "913-345-6960",
            "fax_number": "913-345-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W 110TH ST STE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111215",
            "telephone_number": "913-345-6960",
            "fax_number": "913-345-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "VICTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA10462000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.