Individual provider Active NPI

Diane Coste, NP

  • Nurse Practitioner
  • Medford, MA
National Provider Identifier
1063805851
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
156393 Issued in MA
Practice address
101 Main St
Suite 110
Medford, MA 02155-4540
Phone
(781) 391-2705
Fax
(781) 391-2709
NPI assigned
Mar 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 156393 MA Primary

Addresses

Primary practice location

101 Main St
Suite 110
Medford, MA 02155-4540

Mailing address

101 Main St
Suite 110
Medford, MA 02155-4540
Phone (781) 391-2705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150522000190 MA Practitioner - Nurse Practitioner 4789904301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
156393MAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1063805851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 110",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-391-2705",
            "fax_number": "781-391-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 110",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-391-2705",
            "fax_number": "781-391-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTE",
        "first_name": "DIANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "156393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.