Wanda Coston, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD441753 Issued in PA

Practice address

125 S 9TH St
Philadelphia, PA 19107-5125

Phone

(215) 592-4500

NPI assigned

Sep 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pennsylvania Department of Human Services

  • Psychiatric Hospital
  • Clarks Summit, PA
  • NPI 1447233424
  Medicare reassignment NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881779866
  Medicare reassignment NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1467776989
  NPD
• Public Health Mangement Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1912943457
  NPD

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1417281163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125",
            "telephone_number": "215-592-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125",
            "telephone_number": "215-592-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTON",
        "first_name": "WANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD441753",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD441753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Costello, CRNA
• William John Costello III, DMD
• Alexandra Deanne Costlow, AUD
• Keyana Coston, MSW
• Sherri Coston
• Hannah Cote
• Margarita Cotes, MA
• Reegan Cotey, PHARMD
• Ernest Cotilus III, RPH
• George Cotsarelis, MD

• General Practice Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.