Peter Anthony Costa, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

2019-00398 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-2403

Phone

(336) 713-4500

Fax

(336) 713-4501

NPI assigned

Apr 8, 2013

Last updated

Apr 13, 2021By 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Clinic/Center
  • Statesville, NC
  • NPI 1245757665
  NPD

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1629411855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BEAVER POND CT",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109803518",
            "telephone_number": "845-729-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572403",
            "telephone_number": "336-713-4500",
            "fax_number": "336-713-4501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 Bainbridge Ave # Wayne7",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672403",
            "country_code": "US",
            "telephone_number": "718-741-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTA",
        "first_name": "PETER",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NC",
            "license": "2019-00398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandra Cortes-Espino, FNP-C
• Elvis Cortes
• Emily Cortese
• Anna Ayers Costa, LCMHC-A
• Nicholas Joseph Costa II, MD
• Costco Wholesale Corporation (Costco Hearing Aid #361)
• Costco Wholesale Corporation (Costco Optical #361)
• Costco Wholesale Corporation (Costco Pharmacy)
• Karen Hoke Coston
• Kristie Cothren, MA, CCC-SLP

• Pediatric Gastroenterology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatric Gastroenterology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.