Peter Costa, D.P.M.
Individual provider Active NPI Foot Surgery Podiatrist · Stony Point, NY
NPI 1629048137 · NPPES record last updated Mar 27, 2024
Key facts
- NPI
- 1629048137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- N39101 (NY)
- Practice address
- 7 Liberty Square Mall
Stony Point, NY 10980-2400 - Phone
- (845) 429-0520
- Fax
- (845) 429-0603
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090728000149 | NY | Practitioner - Podiatry | 9032262894 | Reassigns benefits to 1 organization |
| I20130102000138 | NJ | Practitioner - Podiatry | 9032262894 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003910 | NY | MD | Veterinarian |
| N39101 | NY | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Rockland Podiatry PC | Foot Surgery | Current |
Accepting new patients |
| Peter Costa DPM & Associates Inc | Past |
Accepting new patients | |
| Peter Costa, D.P.M. | Past |
Accepting new patients |
Locations
133 N Kinderkamack Rd
Montvale, NJ 07645
Phone (201) 307-4810
7 Liberty Square Mall
Stony Point, NY 10980
Phone (845) 429-0520
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | N39101 | NY | Yes |
Addresses
Primary practice location
7 Liberty Square Mall
Stony Point, NY 10980-2400
Mailing address
7 Liberty Square Mall
Stony Point, NY 10980-2400
Phone (845) 429-0520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00901804 | Medicaid | NY | |
| P41041 | Other | NY | EMPIRE BCBS |
Other providers in Stony Point, NY
- Michelle Joanne Cole-Hatchard
- Justine Conklin
- Dilenia Del Carmen Corona de Rodriguez
- Keane I Cort
- Nicholas Costa
- Corinn Michelle Crawford
- Kaitlin Xiara Cruz
- CVS Albany LLC
- Lynn M Dalton
- Vini Daniel
All providers in Stony Point, NY · Foot Surgery Podiatrist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.