Individual provider Active NPI

Steven Jon Costales, D.C., M.S., A.T.C.

  • Chiropractor
  • Laguna Hills, CA
National Provider Identifier
1689830135
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27735 Issued in CA
Practice address
24741 Alicia Pkwy Ste D
Laguna Hills, CA 92653-4613
Phone
(949) 951-1160
Fax
(949) 951-1107
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27735 CA Primary

Addresses

Primary practice location

24741 Alicia Pkwy Ste D
Laguna Hills, CA 92653-4613

Mailing address

24741 Alicia Pkwy Ste D
Laguna Hills, CA 92653-4613
Phone (949) 951-1160

Other identifiers 3

IdentifierTypeStateIssuer
WDC27735AOtherCAMEDICARE PTAN
202613906OtherCAGROUP NPI
W18889OtherCAMEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000214 CA Practitioner - Chiropractic 6204870439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24741 Alicia Pkwy
Suite D
Laguna Hills, CA 92653-4613
Phone (949) 951-1160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27735CAMDClinical Psychologist
DC27735CAMDChiropractor

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1689830135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24741 ALICIA PKWY STE D",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534613",
            "telephone_number": "949-951-1160",
            "fax_number": "949-951-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24741 ALICIA PKWY STE D",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534613",
            "telephone_number": "949-951-1160",
            "fax_number": "949-951-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTALES",
        "first_name": "STEVEN",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C., M.S., A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WDC27735A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "202613906",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "W18889",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.