Katherine Elizabeth Costa, ACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP3211 Issued in AZ

Practice address

14780 W Mountain View Blvd
Suite 110
Surprise, AZ 85374-4799

Phone

(623) 374-7774

NPI assigned

Nov 1, 2006

Last updated

Sep 17, 2021By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AJJDAA
• FHIR API: https://fhir4.healow.com/fhir/r4/CFIEAA

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.

• Ryan Internal Medicine PC

  • Internal Medicine Physician
  • Flagstaff, AZ
  • NPI 1033225024
  Medicare reassignment NPD
• Arizona Pain and Spine Institute PLLC

  • Interventional Pain Medicine Physician
  • Mesa, AZ
  • NPI 1316147242
  NPD (past)
• Oxford Lung Physicians, P.a.

  • Pulmonary Disease Physician
  • Oxford, MS
  • NPI 1508914102
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1215014485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744799",
            "telephone_number": "623-374-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744799",
            "telephone_number": "623-374-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3211",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "R862053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UNITEDHEALTHCARE",
            "identifier": "P00143146",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05132705",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Core Objectives Physical Therapy
• Samantha Corona
• Michael Coronado
• Chloe L Correa, LPC
• Jessica Cortinas
• Tristan Costanzo
• Costco Wholesale Corporation (Costco Wholesale #1375)
• Costco Wholesale Corporation (Costco Optical #1375)
• Costco Wholesale Corporation (Costco Hearing Aid #1375)
• Nicole Lynn Costello, APRN

• Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.