NPIMap

Organization Active NPI

Concord Plastic Surgery Inc

  • Plastic and Reconstructive Surgery Physician
  • Concord, MA
National Provider Identifier
1073738654
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
CONCORD PLASTIC SURGERY INC
Practice address
131 Ornac
John Cuming Bulding Suite 700
Concord, MA 01742-4177
Phone
(978) 369-1579
Fax
(978) 369-0304
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul David Costas, MDNPI 1801856851
Title
President
Phone
(978) 369-1579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X Primary

Addresses

Primary practice location

131 Ornac
John Cuming Bulding Suite 700
Concord, MA 01742-4177

Mailing address

131 Ornac
John Cuming Buliding Suite 700
Concord, MA 01742-4177
Phone (978) 369-1579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040809000747 MA Part B Supplier - Clinic/Group Practice 4789656968 Receives reassigned benefits from 1 practitioner
Practice locations: Concord, MA

National Provider Directory

National Provider Directory

Locations

131 Ornac
Ste 700
Concord, MA 01742
Phone (978) 369-4499

131 Ornac
Ste 850
Concord, MA 01742
Phone (978) 369-1579

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073738654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ORNAC",
            "address_2": "JOHN CUMING BULIDING SUITE 700",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424177",
            "telephone_number": "978-369-1579",
            "fax_number": "978-369-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ORNAC",
            "address_2": "JOHN CUMING BULDING SUITE 700",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424177",
            "telephone_number": "978-369-1579",
            "fax_number": "978-369-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSTAS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-369-1579",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.