NPIMap

Individual provider Active NPI

Walter Francis D'Costa, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Santa Rosa, CA
National Provider Identifier
1548336605
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E2603 Issued in CA
Practice address
2281 Cleveland Ave
Santa Rosa, CA 95403-2905
Phone
(707) 544-3337
Fax
(707) 544-0608
NPI assigned
Nov 28, 2006
Last updated
Aug 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Podiatrist 213ER0200X RHC116746 CA
Foot & Ankle Surgery Podiatrist 213ES0103X E2603 CA Primary

Addresses

Primary practice location

2281 Cleveland Ave
Santa Rosa, CA 95403-2905

Mailing address

2281 Cleveland Ave
Santa Rosa, CA 95403-2905
Phone (707) 544-3337

Other identifiers 3

IdentifierTypeStateIssuer
170924000OtherUS DEPARTMENT OF LABOR
000E26030MedicaidCA
756480842OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120227000069 CA Practitioner - Podiatry 4486764396 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2281 Cleveland Ave
Santa Rosa, CA 95403-2905
Phone (707) 544-3337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.05 of 100Reported as individual
Quality
79.24
Promoting interoperability
100
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1573
Removal of skin lesions80
Removal of nail tissue1326
Removal or shaving of skin growth453

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RHC116746CAMDRadiology Podiatrist
E2603CAMDFoot & Ankle Surgery Podiatrist
2603CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Willits Hospital Inc. Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

2281 Cleveland Ave
Santa Rosa, CA 95403
Phone (707) 544-3337

Interoperability endpoints

  • Direct secure messaging: wdcosta208967@hisp.ehr.sutterhealth.org

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, 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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1548336605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 CLEVELAND AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032905",
            "telephone_number": "707-544-3337",
            "fax_number": "707-544-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 CLEVELAND AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032905",
            "telephone_number": "707-544-3337",
            "fax_number": "707-544-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'COSTA",
        "first_name": "WALTER",
        "middle_name": "FRANCIS",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "RHC116746",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "170924000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E26030",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "756480842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.