NPIMap

Individual provider Active NPI

Carl Costanza, M.D.

  • Internal Medicine Physician
  • Nutley, NJ
National Provider Identifier
1669400651
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA059660 Issued in NJ
Practice address
187 Chestnut St
Nutley, NJ 07110-2311
Phone
(973) 667-4402
Fax
(973) 667-6974
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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 MA059660 NJ Primary

Addresses

Primary practice location

187 Chestnut St
Nutley, NJ 07110-2311

Mailing address

PO Box 1939
Bloomfield, NJ 07003-1939
Phone (973) 743-2331

Other identifiers 2

IdentifierTypeStateIssuer
0814788000OtherNJAMERIHEALTH
6583709MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050711000021 NJ Practitioner - Internal Medicine 8123054491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

187 Chestnut St
Nutley, NJ 07110-4320
Phone (973) 667-4402

Hospital & facility affiliations

  • Patient Care Home health agency, West Orange, NJ, CCN 317060
  • Barnabas Health Home Care and Hospice Home health agency, West Orange, NJ, CCN 317061
  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Ascend Home Health Home health agency, Rochelle Park, NJ, CCN 317082
  • Barnabas Health Home Care and Hospice Hospice, West Orange, NJ, CCN 311507
  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

Merit-based Incentive Payment System (MIPS)

Final score
24.92 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
83.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059660NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Costanza Medical Associates LLC Internal Medicine Current Accepting new patients
North Arlington Primary Care Assoc. Internal Medicine Past Accepting new patients

Locations

187 Chestnut St
Nutley, NJ 07110
Phone (973) 661-3368

Interoperability endpoints

  • Direct secure messaging: ccostanza243389@epicdirect.rwjbh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1669400651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1939",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070031939",
            "telephone_number": "973-743-2331",
            "fax_number": "973-743-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 CHESTNUT ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102311",
            "telephone_number": "973-667-4402",
            "fax_number": "973-667-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZA",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA059660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0814788000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6583709",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.