Individual provider Active NPI

Jennifer L Costa, AUD.

  • Audiologist
  • Port Jefferson Station, NY
National Provider Identifier
1205080413
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2240 Issued in NY
Practice address
1500 Ny-112
Building 4, 2ND Floor
Port Jefferson Station, NY 11776
Phone
(631) 928-0188
NPI assigned
Nov 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2240 NY Primary

Addresses

Primary practice location

1500 Ny-112
Building 4, 2ND Floor
Port Jefferson Station, NY 11776

Mailing address

660 White Plains Rd FL 4
Tarrytown, NY 10591-5187
Phone (914) 984-2552

Other names 1

  • Miss Jennifer L Borkowski Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000348 NY Practitioner - Qualified Audiologist 0941461008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

1500 Route 112
BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 928-0188

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002240NYMDAcupuncturist
2240NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP CurrentSince Apr 8, 2024 Accepting new patients
Hearusa Inc PastSince Feb 10, 2017 Accepting new patients
Ear, Nose & Throat Associates of New York,P.C. PastSince Feb 1, 1990 Accepting new patients

Locations

400 W Main St
Ste 200
Babylon, NY 11702
Phone (631) 893-6070

240 Patchogue Yaphank Rd
Ste 1
East Patchogue, NY 11772
Phone (631) 654-0550

2929 Express Dr N
Ste 225
Islandia, NY 11749
Phone (631) 665-2430

115 Broadhollow Rd
Ste 150
Melville, NY 11747

146A Manetto Hill Rd
Ste 200
Plainview, NY 11803
Phone (516) 931-5353

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

400 Old Country Rd
Ste 16
Riverhead, NY 11901
Phone (631) 574-3419

365 County Road 39A
Unit 3
Southampton, NY 11968
Phone (631) 283-1142

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

1086 N Broadway
Ste 220
Yonkers, NY 10701
Phone (914) 279-9500

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1205080413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915187",
            "telephone_number": "914-984-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NY-112",
            "address_2": "BUILDING 4, 2ND FLOOR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-928-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AUD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "2240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BORKOWSKI",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.