Rafael Acosta, RAFAEL ACOSTA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14942 Issued in CA

Practice address

222 W. Eulalia Suite 201
Glendale, CA 91204-2851

Phone

(818) 240-0601

NPI assigned

Jun 9, 2010

Last updated

Jun 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: rafael.acosta@4005.securemail.prognocis.com

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1861712150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ELMHURST ST.",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940851",
            "telephone_number": "949-412-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W. EULALIA SUITE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042851",
            "telephone_number": "818-240-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "RAFAEL",
        "name_prefix": "Mr.",
        "credential": "RAFAEL ACOSTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "14942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Acosta Medical Group, Inc.
• Ana Acosta
• Ignacio Acosta, M.D.
• Kimberly Acosta
• Luis Acosta, M.D.
• Act Group LLC
• Act Professional Medical Corporation
• Active Life, LLC
• Active Sports Medicine Clinic
• Activeheal Wound Care

• Physician Assistant in Glendale, CA
• Providers in Glendale, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.