Active NPI
Allen Michael Blackburn Costa, MD
- Ophthalmology Physician
- Alexandria, VA
National Provider Identifier
1740690924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0101289286
- Practice address
- 411 N Washington St
Alexandria, VA 22314-2311 - Phone
- (703) 548-5588
- Fax
- (703) 549-1599
- NPI assigned
- Apr 28, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0101289286 | VA | Primary |
Addresses
Primary practice location
411 N Washington St
Alexandria, VA 22314-2311
Mailing address
2661 Riva Rd Ste 1030
Annapolis, MD 21401-7131
Phone (667) 354-5528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240708000600 | NY | Order and Referring Only - Ophthalmology | 0446794002 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101289286 | VA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1740690924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2661 RIVA RD STE 1030",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017131",
"telephone_number": "667-354-5528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N WASHINGTON ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223142311",
"telephone_number": "703-548-5588",
"fax_number": "703-549-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "ALLEN",
"middle_name": "MICHAEL BLACKBURN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-28",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0101289286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.