Individual provider Active NPI

Alex Costa, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1881124162
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
593 Eddy St
Claverick 2
Providence, RI 02903-4923
Phone
(401) 854-2504
Fax
(401) 854-2504
NPI assigned
Jun 19, 2017
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

593 Eddy St
Claverick 2
Providence, RI 02903-4923

Mailing address

125 Whipple St Ste 3
Providence, RI 02908-3258
Phone (401) 854-2504

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acosta221066@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171014000346 RI Practitioner - Physician Assistant 2062787237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

1500 Pontiac Ave
Suite 101
Cranston, RI 02920-4486
Phone (401) 944-4300

1598 S County TRL
Suite 201
East Greenwich, RI 02818-1762
Phone (401) 884-0333

75 Sockanosset Cross Rd
Cranston, RI 02920-5558
Phone (401) 946-6200

900 Warren Ave
East Providence, RI 02914-1430

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

1500 Pontiac Ave
Ste 101
Cranston, RI 02920
Phone (401) 371-0223

75 Sockanosset Cross Rd
Ste 100
Cranston, RI 02920
Phone (401) 736-4500

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

593 Eddy St
Providence, RI 02903

593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604

78 Baker St
Providence, RI 02905
Phone (401) 781-2400

501 Centerville Rd
Ste 101
Warwick, RI 02886
Phone (401) 606-2680

Interoperability endpoints

  • Direct secure messaging: acosta221066@brownhealth.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1881124162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHIPPLE ST STE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083258",
            "telephone_number": "401-854-2504",
            "fax_number": "401-427-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-854-2504",
            "fax_number": "401-854-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "ALEX",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acosta221066@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "75 Sockanosset Cross Rd Ste 100",
            "city": "Cranston",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029205558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.