Individual provider Active NPI

Marco A Costa, M.D.

  • Cardiovascular Disease Physician
  • Cleveland, OH
National Provider Identifier
1316914047
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
81-000083 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-3800
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MFC1413 FL
Cardiovascular Disease Physician 207RC0000X 81-000076 OH
Cardiovascular Disease Physician 207RC0000X 81-000083 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

3605 Warrensville Center Rd
1St Floor
Shaker Heights, OH 44122-5203
Phone (216) 286-6295

Other identifiers 10

IdentifierTypeStateIssuer
000000539190OtherOHANTHEM
000916022AMedicaidGA
7378305OtherOHAETNA
060068212OtherFLRAILROAD MEDICARE
P00454327OtherOHRAILROAD MEDICARE
2621908-00MedicaidFL
414956OtherOHWELLCARE
000000225199OtherOHUNISON
2770774MedicaidOH
751122OtherOHBUCKEYE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MFC1413FLMDCardiovascular Disease Physician
81-000076OHMDCardiovascular Disease Physician
81-000083OHMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1316914047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 WARRENSVILLE CENTER RD",
            "address_2": "1ST FLOOR",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225203",
            "telephone_number": "216-286-6295",
            "fax_number": "216-286-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "MARCO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "MFC1413",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "81-000076",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "81-000083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000539190",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000916022A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7378305",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060068212",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00454327",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2621908-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "414956",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000225199",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2770774",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "751122",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.