NPIMap

Individual provider Active NPI

Victoria Acosta, DO

  • Family Medicine Physician
  • Mossyrock, WA
National Provider Identifier
1508217365
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61085554 Issued in WA
Practice address
745 Williams St
Mossyrock, WA 98564-9004
Phone
(360) 983-8990
NPI assigned
Jun 23, 2016
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OP61085554 WA Primary
General Practice Physician 208D00000X OP61085554 WA

Addresses

Primary practice location

745 Williams St
Mossyrock, WA 98564-9004

Mailing address

204 Brant Lane
Hoquiam, WA 98550

Other practice location 1

915 Anderson Dr
Aberdeen, WA 98520-1006
Phone (360) 532-8330

Other practice location 2

1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926
Phone (253) 597-4550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address victoriaacosta@myarborhealth.cernerdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913001514 WA Practitioner - Family Practice 0244564250 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis County Hospital District No 1Group PAC ID 6002727385, shared by 7 NPIs, 27 clinicians

Practice addresses (Care Compare)

521 Adams Ave
Morton, WA 98356-9323
Phone (360) 496-5112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP61085554WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care CurrentSince Aug 18, 2021 Accepting new patients
Lewis County Hospital District No 1 Current Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Aug 1, 2021 Accepting new patients
Lewis County Hospital District No. 1 Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Community Health Care CurrentSince Aug 18, 2021 Accepting new patients
Lewis County Hospital District No 1 Family Medicine Past Accepting new patients
Lewis County Hospital District No 1 Past Accepting new patients
Lewis County Hospital District No. 1 Past Accepting new patients

Locations

134 188th St S
Spanaway, WA 98387
Phone (253) 847-2304

1148 Broadway
Ste 100
Tacoma, WA 98402
Phone (253) 268-1170

1202 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 441-4742

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
  • Direct secure messaging: victoriaacosta@myarborhealth.cernerdirect.com

Organizations & group practices 8

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 4

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1508217365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BRANT LANE",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "98550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 WILLIAMS ST",
            "city": "MOSSYROCK",
            "state": "WA",
            "postal_code": "985649004",
            "telephone_number": "360-983-8990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "985201006",
            "country_code": "US",
            "telephone_number": "360-532-8330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984053926",
            "country_code": "US",
            "telephone_number": "253-597-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61085554",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "OP61085554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victoriaacosta@myarborhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "745 Williams St",
            "city": "Mossyrock",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985649004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mossyrock, WA

Sources for this page

Verify at the official NPI Registry.