Active NPI
Peter N Costa, MD
- Physical Medicine & Rehabilitation Physician
- Carson City, NV
National Provider Identifier
1821089293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 7813
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2013381 | Medicaid | NV | |
| NV9682 | Other | NV | BCBS |
| 00G703180 | Other | CA | MEDI-CAL |
| 250010880 | Other | CA | MEDICARE 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| G70318 | CA | MD | Physical Medicine & Rehabilitation Physician |
| 7813 | NV | MD | Physical Medicine & Rehabilitation Physician |
| 7813 | CA | MD | Occupational Therapist |
| 7813 | NC | MD | Occupational 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.