Marc Lance Costa, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19442 Issued in WV

Practice address

527 Medical Park Dr
Suite 202
Bridgeport, WV 26330-9008

Phone

(304) 933-3850

Fax

(304) 933-3859

NPI assigned

Jul 5, 2006

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Perelman School of Med at the University of Pennsylvania, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marccosta@css.allscriptsdirect.net
• Direct secure messaging: mcosta1@direct.excelahealth.org

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.

• United Hospital Center, Inc.

  • Internal Medicine Physician
  • Bridgeport, WV
  • NPI 1760965586

  Surgery

  Medicare reassignment Care Compare group NPD
• United Hospital Center, Inc.

  dba UHC General Surgery

  • Surgery Physician
  • Bridgeport, WV
  • NPI 1720349905
  NPD
• United Hospital Center

  • Rheumatology Physician
  • Bridgeport, WV
  • NPI 1780767772
  NPD (past)
• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  NPD (past)
• Excela Health Physician Practices, Inc.

  dba Walk-in Clinic

  • Family Medicine Physician
  • Greensburg, PA
  • NPI 1235004193
  NPD (past)

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

• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1184655482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR",
            "address_2": "SUITE 202",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309008",
            "telephone_number": "304-933-3850",
            "fax_number": "304-933-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR",
            "address_2": "SUITE 202",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309008",
            "telephone_number": "304-933-3850",
            "fax_number": "304-933-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "MARC",
        "middle_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD060675L",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "19442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON THREE RIVERS",
            "identifier": "000000140320",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3133024",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019436000001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA MEDICARE",
            "identifier": "G78377",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC MEDICARE",
            "identifier": "319922",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "G78377",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1531290",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "G78377",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "048032003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1461312",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcosta32628@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "527 Medical Park Dr Ste 202",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcosta32628@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "527 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Marie Conway
• James Robert Cooper, PTA
• Molly Cooper, OTR/L
• Cornerstone Pediatric Therapy Center, LLC (Cornerstone Pediatric Center, LLC)
• Creel S Cornwell, M.D.
• Caleb Henry Cotner, DO
• Christopher Don Courtney, DO
• James Thomas Courtney, DDS
• Suzanne Whitney Courtney, MD
• Mindy Sue Cox

• Surgery Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.