Active NPI
Patricia Ann Costanzo, M.D.
- Pulmonary Disease Physician
- Savannah, GA
National Provider Identifier
1689672438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 036709
- Practice address
- 4 Sea Oats LN
Savannah, GA 31411-3102 - Phone
- (912) 598-3960
- Fax
- (912) 598-3961
- NPI assigned
- Jul 14, 2005
- Last updated
- Jun 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 036709 | GA | Primary |
Addresses
Primary practice location
4 Sea Oats LN
Savannah, GA 31411-3102
Mailing address
4 Sea Oats LN
Savannah, GA 31411-3102
Phone (912) 598-3960
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 768294 | Other | GA | BLUECROSS BLUESHIELD |
| G36709 | Medicaid | SC | |
| 000835986C | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleepcare Institute, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Sleep Disorder Diagnostic Clinic/Center
- Stockbridge, GA
- NPI 1629173109
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1689672438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SEA OATS LN",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314113102",
"telephone_number": "912-598-3960",
"fax_number": "912-598-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SEA OATS LN",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314113102",
"telephone_number": "912-598-3960",
"fax_number": "912-598-3961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANZO",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-14",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "GA",
"license": "036709",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "768294",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G36709",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000835986C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.