Active NPI
Judith Ness Costa, PNP
- Family Nurse Practitioner
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP95007752
- Practice address
- 4060 Fairmount Ave
San Diego, CA 92105-1608 - Phone
- (619) 280-4213
- NPI assigned
- Apr 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP95007752 | CA | Primary |
Addresses
Primary practice location
4060 Fairmount Ave
San Diego, CA 92105-1608
Mailing address
4060 Fairmount Ave
San Diego, CA 92105-1608
Phone (619) 280-4213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95007752 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| La Maestra Family Clinic, Inc. | Current | Accepting new patients | |
| La Maestra Family Clinic Inc. | Current | Accepting new patients | |
| La Maestra Family Clinic, Inc. | Current | Accepting new patients |
Locations
165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347
4725 Market St
San Diego, CA 92102
Phone (619) 515-2560
4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
Interoperability endpoints
- judith.costa.p1@direct.lamaestra.nextgenshare.com
- judith.costa.p1@direct.scfhc.nextgenshare.com
Organizations & group practices 6
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.
-
dba Logan Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
dba La Maestra Community Health Centers
- Federally Qualified Health Center (FQHC)
- El Cajon, CA
- NPI 1306929443
-
dba Chula Vista Family Health Center
- Federally Qualified Health Center (FQHC)
- Chula Vista, CA
- NPI 1346480837
-
dba Escondido Physical Health and Wellness
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
-
dba La Maestra Community Health Centers
- Health Service Clinic/Center
- El Cajon, CA
- NPI 1740881085
-
dba La Maestra Community Health Centers
- Federally Qualified Health Center (FQHC)
- El Cajon, CA
- NPI 1568209773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717286400000",
"number": "1932696960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 FAIRMOUNT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921051608",
"telephone_number": "619-280-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 FAIRMOUNT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921051608",
"telephone_number": "619-280-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "JUDITH",
"middle_name": "NESS",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-16",
"last_updated": "2024-06-02",
"certification_date": "2024-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP95007752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; 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.