Thao L Costanza, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN2267066 Issued in MA

Practice address

110 Francis St
Boston, MA 02215-5501

Phone

(617) 632-7246

NPI assigned

Dec 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
• Exeter Hospital Inc Hospital, Exeter, NH, CCN 300023

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1194765438
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Surgery Physician
  • Boston, MA
  • NPI 1720037385
  Medicare reassignment NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce

  • Body Imaging Physician
  • Boston, MA
  • NPI 1275574899
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation
• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Exeter Hospital Inc

  • General Acute Care Hospital
  • Exeter, NH
  • NPI 1437158433
  Care Compare affiliation

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1114433323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 VINE ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021494827",
            "telephone_number": "857-363-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018055501",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTANZA",
        "first_name": "THAO",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2267066",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2267066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ann Costa, PT
• Christian Carlo Dela Cruz Costales, DPM
• Luis Antonio Costales Sr.
• Christina L Costantino, MD
• Tracey Anne Costantino, NP
• Mark A Costanzo, NP
• Karen C Costas, RD
• Amanda Christine Costello Riordan, DMD
• Casey Elizabeth Costello
• Daniel J Costello, M.D.

• Gerontology Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.