NPIMap

Individual provider Active NPI

Leonardo Filipe Costa, NP

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1124453386
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN03067 Issued in RI
Practice address
180 Corliss St Ste C
Providence, RI 02904-2602
Phone
(401) 793-4636
Fax
(401) 793-4639
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN03067 RI Primary
Registered Nurse 163W00000X RN52152 RI

Addresses

Primary practice location

180 Corliss St Ste C
Providence, RI 02904-2602

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20220606002016 RI Practitioner - Nurse Practitioner 3274911185 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN52152RIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital CurrentSince Jul 3, 2022 Accepting new patients
The Miriam Hospital CurrentSince Jul 3, 2022 Accepting new patients
Lifespan Corporation Current Accepting new patients
The Miriam Hospital CurrentSince Jan 20, 2024 Accepting new patients
The Miriam Hospital Current Accepting new patients

Locations

180 Corliss St
Ste E2
Providence, RI 02904
Phone (401) 793-2928

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

180 Corliss St
Ste F
Providence, RI 02904
Phone (401) 793-4715

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

180 Corliss St
Ste E1
Providence, RI 02904
Phone (401) 793-2928

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

180 Corliss St
Ste C
Providence, RI 02904
Phone (401) 793-4636

Interoperability endpoints

  • Direct secure messaging: lcosta13344@brownhealth.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Miriam Hospital 178 clinicians

Practice addresses (Care Compare)

180 Corliss St
Providence, RI 02904-2602

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

NPI Registry JSON

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1124453386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE C",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-4636",
            "fax_number": "401-793-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "LEONARDO",
        "middle_name": "FILIPE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03067",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN52152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.