Individual provider Active NPI

Meghan Ryan Costa, P.A.

  • Medical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1255605697
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015310-1 Issued in NY
Practice address
736 Irving Ave
Suite 9100 Neonatal Associates of Central New York P.C.
Syracuse, NY 13210
Phone
(315) 470-7379
Fax
(315) 470-2923
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015310-1 NY Primary

Addresses

Primary practice location

736 Irving Ave
Suite 9100 Neonatal Associates of Central New York P.C.
Syracuse, NY 13210

Mailing address

736 Irving Ave
Suite 910 Neonatal Associates of Central New York P.C.
Syracuse, NY 13210-1690
Phone (315) 470-7379

Other identifiers 1

IdentifierTypeStateIssuer
015310-1OtherNYNEW YORK STATE LICENSE

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015310-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neonatal Medical Transport PLLC Past Accepting new patients
Neonatal Associates of Central New York PC Past Accepting new patients

Organizations & group practices 2

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": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1255605697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "address_2": "SUITE 910 NEONATAL ASSOCIATES OF CENTRAL NEW YORK P.C.",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101690",
            "telephone_number": "315-470-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "address_2": "SUITE 9100 NEONATAL ASSOCIATES OF CENTRAL NEW YORK P.C.",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-470-7379",
            "fax_number": "315-470-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "MEGHAN",
        "middle_name": "RYAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015310-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "015310-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.