Individual provider Active NPI

Peter N Costa, MD

  • Physical Medicine & Rehabilitation Physician
  • Carson City, NV
National Provider Identifier
1821089293
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
7813 Issued in NV
Practice address
973 Mica Drive
Suite 201
Carson City, NV 89705-7255
Phone
(775) 783-6190
Fax
(775) 783-6191
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G70318 CA
Physical Medicine & Rehabilitation Physician 208100000X 7813 NV Primary

Addresses

Primary practice location

973 Mica Drive
Suite 201
Carson City, NV 89705-7255

Mailing address

973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone (775) 783-6190

Other identifiers 4

IdentifierTypeStateIssuer
2013381MedicaidNV
NV9682OtherNVBCBS
00G703180OtherCAMEDI-CAL
250010880OtherCAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000501 NV Practitioner - Physical Medicine and Rehabilitation 4981651411 Practice locations: Gardnerville, NV; Carson City, NV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70318CAMDPhysical Medicine & Rehabilitation Physician
7813NVMDPhysical Medicine & Rehabilitation Physician
7813CAMDOccupational Therapist
7813NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1821089293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 MICA DRIVE",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "PETER",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G70318",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": "7813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013381",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV9682",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00G703180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "250010880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.