Individual provider Active NPI

Craig J Acosta, PA-C

  • Surgical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1467416479
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9104144 Issued in FL
Practice address
836 Prudential Dr
Ste 1804
Jacksonville, FL 32207
Phone
(904) 398-3888
Fax
(904) 400-6675
NPI assigned
Apr 14, 2006
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9104144 FL Primary
Surgical Physician Assistant 363AS0400X 2025040000 MO

Addresses

Primary practice location

836 Prudential Dr
Ste 1804
Jacksonville, FL 32207

Mailing address

1824 King St Ste 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Other practice location 1

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-3960

Other identifiers 2

IdentifierTypeStateIssuer
000591100MedicaidFL
P00798356OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081231000246 FL Practitioner - Physician Assistant 9931286002 Reassigns benefits to 1 organization
I20251208000259 MO Practitioner - Physician Assistant 9931286002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
2C SPRG Cardiothoracic Surgery Heart
Springfield, MO 65804-2203
Phone (417) 820-3960

1824 King St
Suite 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

836 Prudential Dr
Suite 1804
Jacksonville, FL 32207-8345
Phone (904) 398-3888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7031NYMDChiropractor
2025040000MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 24, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 24, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 24, 2025 Accepting new patients
Advanced Cardiac Surgical Associates, PLLC Past Accepting new patients
Baptist MD Anderson Cancer Physicians Inc PastSince Apr 16, 2023 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

1235 E Cherokee St
Ste 2C
Springfield, MO 65804
Phone (417) 820-3919

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: craigacosta@cvsapa.allscriptsdirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1467416479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-384-3343",
            "fax_number": "904-400-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "STE 1804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-398-3888",
            "fax_number": "904-400-6675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 E Cherokee St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042203",
            "country_code": "US",
            "telephone_number": "417-820-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "CRAIG",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104144",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2025040000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000591100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00798356",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.