Individual provider Active NPI

Charlene Edmee D'Acosta, MD

  • General Practice Physician
  • Port Richey, FL
National Provider Identifier
1306802905
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN813 Issued in FL
Practice address
10085 US Highway 19 Ste Gte
Port Richey, FL 34668-3742
Phone
(727) 810-8062
Fax
(727) 810-8064
NPI assigned
Apr 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN813 FL Primary

Addresses

Primary practice location

10085 US Highway 19 Ste Gte
Port Richey, FL 34668-3742

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (727) 322-3439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718001032 FL Practitioner - General Practice 6002828076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Associates LLCGroup PAC ID 0648271155, 162 clinicians

Practice addresses (Care Compare)

10085 US Hwy 19
Suite Gte
Port Richey, FL 34668-3742
Phone (727) 810-8062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN813FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asociacion Hospital del Maestro Inc Past Accepting new patients
Orlando Family Physicians, LLC General Practice PastSince Jan 5, 2025 Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1306802905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "727-322-3439",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 US HIGHWAY 19 STE GTE",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346683742",
            "telephone_number": "727-810-8062",
            "fax_number": "727-810-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ACOSTA",
        "first_name": "CHARLENE",
        "middle_name": "EDMEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

Verify at the official NPI Registry.