Individual provider Active NPI

Virginia C Costagliola, RPA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1396819223
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007648 Issued in NY
Practice address
234 E 149TH St
Dept of Emergency Medicine Lincoln Hospital
Bronx, NY 10451-5504
Phone
(718) 579-6010
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 007648 NY Primary

Addresses

Primary practice location

234 E 149TH St
Dept of Emergency Medicine Lincoln Hospital
Bronx, NY 10451-5504

Mailing address

1910 Parsons Blvd Apt 4D
Whitestone, NY 11357-3007
Phone (718) 746-4918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070612000574 NY Practitioner - Physician Assistant 8123126505 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007648NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital United States Catholic Conference CurrentSince Jan 16, 2019 Accepting new patients
St. Francis Hospital CurrentSince Jan 16, 2019 Accepting new patients
LH Emergency Medical Services PC Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396819223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PARSONS BLVD APT 4D",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573007",
            "telephone_number": "718-746-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "DEPT OF EMERGENCY MEDICINE LINCOLN HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTAGLIOLA",
        "first_name": "VIRGINIA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.