Nicholas Joseph Costa II, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

2019-00725 Issued in NC

Practice address

186 Kimel Park Dr
Winston Salem, NC 27103

Phone

(336) 277-2000

Fax

(336) 277-2050

NPI assigned

Apr 8, 2011

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
• Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
• Twin County Regional Hospital Hospital, Galax, VA, CCN 490115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ncosta733259@direct.novanthealth.org

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.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Medical Park Hospital LLC

  dba Medical Park Professional Fee

  • Specialist
  • Winston Salem, NC
  • NPI 1003867516
  Medicare reassignment NPD
• Novant Health Ballantyne Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1760190607
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  dba Professional Fees

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404
  Medicare reassignment NPD
• The Presbyterian Hospital

  dba Novant Health Senior Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1053365817
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  dba Novant Health Cardiology

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1114200771
  NPD
• Forsyth Memorial Hospital, Inc.

  dba FMC Professional Fees

  • Specialist
  • Winston Salem, NC
  • NPI 1154371052
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Medical Park Hospital LLC

  dba Novant Health Medical Park Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1538111828
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Northern Hospital of Surry County

  dba North Hospital of Surry County

  • General Acute Care Hospital
  • Mount Airy, NC
  • NPI 1366449282
  Care Compare affiliation
• DLP Twin County Regional Healthcare LLC

  dba Twin County Regional Hospital

  • General Acute Care Hospital
  • Galax, VA
  • NPI 1114292141
  Care Compare affiliation
• DLP Twin County Regional Healthcare LLC

  • Physical Therapy Clinic/Center
  • Galax, VA
  • NPI 1801161369

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1629368931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 W Redwood St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011734",
            "country_code": "US",
            "telephone_number": "410-328-7877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 W Redwood St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011734",
            "country_code": "US",
            "telephone_number": "410-328-7877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTA",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0079810",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-00725",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2019-00725",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "2019-00725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncosta733259@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "419 W Redwood St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212011734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mayra Cortes Arciniega
• Alejandra Cortes-Espino, FNP-C
• Elvis Cortes
• Emily Cortese
• Anna Ayers Costa, LCMHC-A
• Peter Anthony Costa, MD
• Costco Wholesale Corporation (Costco Hearing Aid #361)
• Costco Wholesale Corporation (Costco Optical #361)
• Costco Wholesale Corporation (Costco Pharmacy)
• Karen Hoke Coston

• Clinical Cardiac Electrophysiology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Cardiac Electrophysiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.