NPIMap

Individual provider Active NPI

Mary Elizabeth Acosta

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1295480952
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5016136 Issued in NC
Practice address
200 Greenwich Rd
Charlotte, NC 28211-2316
Phone
(704) 384-8680
Fax
(704) 384-8684
NPI assigned
Feb 21, 2022
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5016136 NC Primary

Addresses

Primary practice location

200 Greenwich Rd
Charlotte, NC 28211-2316

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2501 Lincolnton Highway
Cherryville, NC 28021
Phone (205) 545-5090

Other names 1

  • Beth Acosta Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220509002123 NC Practitioner - Nurse Practitioner 8426435637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5016136NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Mar 25, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 5, 2024 Accepting new patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Mar 25, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 5, 2024 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

200 Greenwich Rd
Charlotte, NC 28211
Phone (704) 384-8680

2501 Lincolnton Hwy
Cherryville, NC 28021
Phone (205) 545-5090

130 James Ave
Locust, NC 28097
Phone (704) 271-3777

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: macosta1233492@direct.novanthealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1295480952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREENWICH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112316",
            "telephone_number": "704-384-8680",
            "fax_number": "704-384-8684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Lincolnton Highway",
            "address_purpose": "LOCATION",
            "city": "Cherryville",
            "state": "NC",
            "postal_code": "28021",
            "country_code": "US",
            "telephone_number": "205-545-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "ACOSTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.