Individual provider Active NPI

Anthony Dicostanzo, NP

  • Nurse Practitioner
  • South Daytona, FL
National Provider Identifier
1891584777
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11039273 Issued in FL
Practice address
401 Venture Dr
South Daytona, FL 32119-3478
Phone
(386) 761-8888
NPI assigned
May 6, 2025
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11039273 FL Primary

Addresses

Primary practice location

401 Venture Dr
South Daytona, FL 32119-3478

Mailing address

401 Venture Dr
South Daytona, FL 32119-3478
Phone (386) 837-0958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250825003391 FL Practitioner - Nurse Practitioner 0143720060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ormond Medical ArtsGroup PAC ID 1254222565, 38 clinicians

Practice addresses (Care Compare)

401 Venture Dr
Suite a
South Daytona, FL 32119-3475
Phone (386) 761-8888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11039273FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ormond Medical Arts Family Practice LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

800 N Stone St
Deland, FL 32720
Phone (386) 736-4912

1180 W Granada Blvd
Ste B
Ormond Beach, FL 32174
Phone (386) 676-2606

77 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 677-0453

401 Venture Dr
Ste A
South Daytona, FL 32119
Phone (386) 761-8888

Interoperability endpoints

  • Direct secure messaging: anthony.dicostanzo.1@15135.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4

Organizations & group practices 1

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 5

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": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1891584777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 VENTURE DR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193478",
            "telephone_number": "386-837-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 VENTURE DR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193478",
            "telephone_number": "386-761-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICOSTANZO",
        "first_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11039273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.