Individual provider Active NPI

Constantina Kostka, PA

  • Medical Physician Assistant
  • Brighton, MA
National Provider Identifier
1326596396
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
S71060502 Issued in MA
Practice address
1560 Commonwealth Ave
Apt. #16
Brighton, MA 02135-5038
Phone
(617) 312-5056
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 S71060502 MA Primary

Addresses

Primary practice location

1560 Commonwealth Ave
Apt. #16
Brighton, MA 02135-5038

Mailing address

1560 Commonwealth Ave
Apt. #16
Brighton, MA 02135-5038
Phone (617) 312-5056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207001430 MA Practitioner - Physician Assistant 2264712371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha'S Vineyard Hospital IncGroup PAC ID 9931166113, 150 clinicians

Practice addresses (Care Compare)

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone 508693041079525

Hospital & facility affiliations

  • Martha'S Vineyard Hospital Inc Hospital, Oak Bluffs, MA, CCN 221300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
S71060502MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Hospital Current Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince May 21, 2019 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince May 21, 2019 Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

Interoperability endpoints

  • Direct secure messaging: kostka.constantina.mvh@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1326596396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 COMMONWEALTH AVE",
            "address_2": "APT. #16",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355038",
            "telephone_number": "617-312-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 COMMONWEALTH AVE",
            "address_2": "APT. #16",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355038",
            "telephone_number": "617-312-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTKA",
        "first_name": "CONSTANTINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "S71060502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.