Individual provider Active NPI

Daniel Alejandro Acosta, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1639798127
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS023729 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-3797
NPI assigned
Apr 14, 2020
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS023729 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240405001686 FL Practitioner - Internal Medicine 3678911997 Reassigns benefits to 1 organization
I20240509002283 PA Practitioner - Internal Medicine 3678911997 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS023729PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Collins Physician Services, LLC Internal Medicine CurrentSince Feb 27, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients

Locations

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 3

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1639798127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-674-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "DANIEL",
        "middle_name": "ALEJANDRO",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS023729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.