Active NPI
Antoinette Geraldine Costa, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- East Orange, NJ
National Provider Identifier
1790791671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 25 MA 04272000
- Practice address
- 385 Tremont Ave
East Orange, NJ 07018-1023 - Phone
- (973) 676-1000
- Fax
- (973) 395-7010
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 25 MA 04272000 | NJ | Primary |
Addresses
Primary practice location
385 Tremont Ave
East Orange, NJ 07018-1023
Mailing address
181 McMane Ave
Berkeley Heights, NJ 07922-2202
Phone (908) 665-2087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- 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 |
|---|---|---|---|---|
| I20130507000181 | NJ | Order and Referring Only - Internal Medicine | 4082893441 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25 MA 04272000 | NJ | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790791671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 MCMANE AVE",
"city": "BERKELEY HEIGHTS",
"state": "NJ",
"postal_code": "079222202",
"telephone_number": "908-665-2087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 TREMONT AVE",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070181023",
"telephone_number": "973-676-1000",
"fax_number": "973-395-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "ANTOINETTE",
"middle_name": "GERALDINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NJ",
"license": "25 MA 04272000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.