Individual provider Active NPI

Queenie Mousumi D'Costa, MD

  • Pediatric Critical Care Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1588877435
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME102726 Issued in FL
Practice address
3705 5TH Ave
Pittsburgh, PA 15213-2584
Phone
(412) 692-5164
Fax
(412) 692-6076
NPI assigned
May 8, 2007
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X P1451 TX
Pediatric Critical Care Medicine Physician 2080P0203X MD424352 PA
Pediatric Critical Care Medicine Physician 2080P0203X ME102726 FL Primary

Addresses

Primary practice location

3705 5TH Ave
Pittsburgh, PA 15213-2584

Mailing address

200 Lothrop St
Forbes Tower Suite 9055
Pittsburgh, PA 15213-2536
Phone (412) 647-3087

Other practice location 1

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-5700

Other practice location 2

4845 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-5700

Other identifiers 1

IdentifierTypeStateIssuer
000383900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120406000234 TX Practitioner - Pediatric MedicinePractitioner - Other (Physician) 2264539782 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD424352PAMDPediatric Critical Care Medicine Physician
P1451TXMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Pediatric Critical Care Medicine CurrentSince Jun 1, 2023 Accepting new patients
Magella Medical Associates Billing, Inc. CurrentSince Nov 9, 2018 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jun 1, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Pediatric Critical Care Medicine CurrentSince Jun 1, 2018 Accepting new patients
Chca Womans Hospital LP Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

4845 Alameda Ave
El Paso, TX 79905
Phone (915) 215-5700

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

7600 Fannin St
Houston, TX 77054
Phone (713) 791-7115

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1588877435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "address_2": "FORBES TOWER SUITE 9055",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "412-647-3087",
            "fax_number": "412-647-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 5TH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132584",
            "telephone_number": "412-692-5164",
            "fax_number": "412-692-6076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4845 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'COSTA",
        "first_name": "QUEENIE",
        "middle_name": "MOUSUMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "P1451",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD424352",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME102726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000383900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.