Enhanced Medical Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

54772 Issued in MA

Legal business name

ENHANCED MEDICAL CARE, LLC

Practice address

361 Woodward St
Waban, MA 02468-2027

Phone

(617) 777-4080

Fax

(617) 344-0070

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Edward Costa, M.D.NPI 1912997420

Title

Partner

Phone

(617) 777-4080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Edward Costa, MD

  • Internal Medicine Physician
  • Waban, MA
  • NPI 1912997420
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952525867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 WOODWARD ST",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024682027",
            "telephone_number": "617-777-4080",
            "fax_number": "617-344-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 WOODWARD ST",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024682027",
            "telephone_number": "617-777-4080",
            "fax_number": "617-344-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED MEDICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-777-4080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "54772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3131874",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Anne Dean, PSYD
• Kayla Lauren Devine
• Katherine Marie Dooley, LIC. AC.
• Catherine Ione Dubois, PSY.D.
• Ease Psychotherapy, PLLC
• Evergreen Consulting Group
• Stuart A Ezrin, DC
• Trudy S Fagen, LMHC
• Jennifer A Ford, PSY.D.
• Marilyn Grimes Fraktman, RN, PH D

• Internal Medicine Physician in Waban, MA
• Providers in Waban, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.