Individual provider Active NPI

Orlando Dacosta, REGISTERED NURSE

  • Registered Nurse
  • Shelton, CT
National Provider Identifier
1457786964
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
873854 Issued in NY
Practice address
47 Fort Hill Ave
Shelton, CT 06484-2206
Phone
(917) 287-4025
NPI assigned
Sep 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 311999 NY
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 873854 NY Primary

Addresses

Primary practice location

47 Fort Hill Ave
Shelton, CT 06484-2206

Mailing address

47 Fort Hill Ave
Shelton, CT 06484-2206
Phone (917) 287-4025

Other practice location 1

3029 Colden Ave
Bronx, NY 10469-3908
Phone (917) 287-4025

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

State licenses

LicenseStateTypeSpecialty
873854NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1457786964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 FORT HILL AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064842206",
            "telephone_number": "917-287-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 FORT HILL AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064842206",
            "telephone_number": "917-287-4025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3029 Colden Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104693908",
            "country_code": "US",
            "telephone_number": "917-287-4025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ORLANDO",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "311999",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "873854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.