Individual provider Active NPI

Ernest Costantino Jr., M.D.

  • Urology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1245560457
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME 13947 Issued in FL
Practice address
768 Middle River Dr
Fort Lauderdale, FL 33304-3512
Phone
(954) 563-5168
NPI assigned
Jan 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME 13947 FL Primary

Addresses

Primary practice location

768 Middle River Dr
Fort Lauderdale, FL 33304-3512

Mailing address

768 Middle River Drive
Fort Lauderdale, FL 33304
Phone (954) 563-5168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 13947FLMDUrology Physician

Interoperability endpoints

  • Direct secure messaging: ernest.costantino.1@16705.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1245560457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 MIDDLE RIVER DRIVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33304",
            "telephone_number": "954-563-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 MIDDLE RIVER DR",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043512",
            "telephone_number": "954-563-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANTINO",
        "first_name": "ERNEST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 13947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.