Individual provider Active NPI

Ronald Don Costa

  • Community Based Hospice Care Agency
  • Las Vegas, NV
National Provider Identifier
1366205775
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Practice address
6655 W Sahara Ave Ste 113-114
Las Vegas, NV 89146-0842
Phone
(615) 713-7465
NPI assigned
Jan 31, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

6655 W Sahara Ave Ste 113-114
Las Vegas, NV 89146-0842

Mailing address

192 Macoby Run St
Las Vegas, NV 89148-2628
Phone (615) 713-7465

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goodwill Health Care LLC Hospice Care, Community Based CurrentSince Feb 18, 2024 Accepting new patients

Locations

6655 W Sahara Ave
Ste 113114
Las Vegas, NV 89146
Phone (615) 713-7465

Organizations & group practices 1

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1366205775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 MACOBY RUN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482628",
            "telephone_number": "615-713-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE STE 113-114",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "615-713-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "RONALD DON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.