Individual provider Active NPI

Ricardo F Costa, PT

  • Physical Therapist
  • Chatham, NJ
National Provider Identifier
1407938277
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01224500 Issued in NJ
Practice address
641 Shunpike Rd
Chatham, NJ 07928-1567
Phone
(973) 520-4940
Fax
(973) 520-4941
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01224500 NJ Primary

Addresses

Primary practice location

641 Shunpike Rd
Chatham, NJ 07928-1567

Mailing address

641 Shunpike Rd
Chatham, NJ 07928-1567
Phone (973) 520-4940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070312000001 NJ Practitioner - Physical Therapist in Private Practice 1759484884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results Physical Therapy InstituteGroup PAC ID 3577898121, 3 clinicians

Practice addresses (Care Compare)

641 Shunpike Rd
Chatham, NJ 07928-1567
Phone (973) 520-4940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Results Physical Therapy Institute CurrentSince Mar 25, 2019 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince May 26, 2012 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

40 Main St
Chatham, NJ 07928
Phone (973) 635-0800

466 Southern Blvd
Chatham Twp, NJ 07928
Phone (973) 370-9944

641 Shunpike Rd
Chatham Twp, NJ 07928
Phone (201) 377-5566

609 Morris Ave
Ste 2
Springfield, NJ 07081
Phone (973) 671-3200

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1407938277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 SHUNPIKE RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281567",
            "telephone_number": "973-520-4940",
            "fax_number": "973-520-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 SHUNPIKE RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281567",
            "telephone_number": "973-520-4940",
            "fax_number": "973-520-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "RICARDO",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01224500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.