Active NPI
Jonathan Costa
- Physician Assistant
- Miami, FL
National Provider Identifier
1811546161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 255-P.A.
- Practice address
- 9415 Fontainebleau Blvd Apt 106
Miami, FL 33172-5571 - Phone
- (786) 307-1151
- NPI assigned
- Sep 10, 2019
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 255-P.A. | PR | Primary |
Addresses
Primary practice location
9415 Fontainebleau Blvd Apt 106
Miami, FL 33172-5571
Mailing address
9415 Fontainebleau Blvd Apt 106
Miami, FL 33172-5571
Phone (786) 307-1151
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 255-P.A. | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1811546161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9415 FONTAINEBLEAU BLVD APT 106",
"city": "MIAMI",
"state": "FL",
"postal_code": "331725571",
"telephone_number": "786-307-1151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9415 FONTAINEBLEAU BLVD APT 106",
"city": "MIAMI",
"state": "FL",
"postal_code": "331725571",
"telephone_number": "786-307-1151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "255-P.A.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.