Active NPI
Jose Costa, MD
- Anatomic Pathology Physician
- New Haven, CT
National Provider Identifier
1083603617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 032845
- Practice address
- 310 Cedar St
Lauder Hall Room 108
New Haven, CT 06510-3218 - Phone
- (203) 785-2788
- NPI assigned
- Oct 17, 2005
- Last updated
- Jun 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 032845 | CT | Primary |
Addresses
Primary practice location
310 Cedar St
Lauder Hall Room 108
New Haven, CT 06510-3218
Mailing address
PO Box 9805
300 George St, 6TH Floor
New Haven, CT 06536-0805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032845 | CT | MD | Anatomic Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1083603617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9805",
"address_2": "300 GEORGE ST, 6TH FLOOR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065360805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 CEDAR ST",
"address_2": "LAUDER HALL ROOM 108",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103218",
"telephone_number": "203-785-2788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "JOSE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "CT",
"license": "032845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.