Individual provider Active NPI

Milton S Costa, M.D.

  • General Practice Physician
  • Charleston, SC
National Provider Identifier
1629142674
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11841 Issued in SC
Practice address
325 Folly Rd Ste 102a
Charleston, SC 29412-2507
Phone
(843) 762-1440
Fax
(843) 762-6979
NPI assigned
Nov 20, 2006
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11841 SC Primary

Addresses

Primary practice location

325 Folly Rd Ste 102a
Charleston, SC 29412-2507

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 2

IdentifierTypeStateIssuer
P00727234OtherSCRAILROAD MEDICARE ID- RSFPP
118410MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Milton.Costa@rsfpp.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20071024000055 SC Practitioner - General Practice 5890685556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11841SCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network General Practice CurrentSince May 1, 2009 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 1, 2009 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

1 S Park Cir
Ste 400
Charleston, SC 29407
Phone (843) 789-1651

325 Folly Rd
Ste 102A
Charleston, SC 29412
Phone (843) 762-1440

347 Folly Rd
Charleston, SC 29412
Phone (843) 762-1440

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Interoperability endpoints

  • Direct secure messaging: milton.costa@rsfpp.eclinicaldirectplus.com

Organizations & group practices 4

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1629142674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 FOLLY RD STE 102A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122507",
            "telephone_number": "843-762-1440",
            "fax_number": "843-762-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "MILTON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "11841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID- RSFPP",
            "identifier": "P00727234",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118410",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Milton.Costa@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "325 Folly Rd Ste 102A",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294122507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.