Individual provider Active NPI

Irina Costa

  • Nurse Practitioner
  • Clark, NJ
National Provider Identifier
1952786246
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00578500 Issued in NJ
Practice address
31 Union County Pkwy
Clark, NJ 07066-1917
Phone
(908) 531-5543
NPI assigned
Jul 28, 2015
Last updated
Jul 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00578500 NJ Primary
Registered Nurse 163W00000X 26NR12516100 NJ

Addresses

Primary practice location

31 Union County Pkwy
Clark, NJ 07066-1917

Mailing address

31 Union County Pkwy
Clark, NJ 07066-1917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150922001938 NJ Practitioner - Nurse Practitioner 9032426192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Specialists of Morris County, LLCGroup PAC ID 8224192257, 2 clinicians

Practice addresses (Care Compare)

101 Madison Ave
Suite 304
Morristown, NJ 07960-7305
Phone (973) 292-0999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR12516100NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Specialists of Morris County, LLC CurrentSince Aug 17, 2015 Accepting new patients

Locations

101 Madison Ave
Ste 304
Morristown, NJ 07960
Phone (973) 292-0999

1000 Galloping Hill Rd
Union, NJ 07083
Phone (908) 522-6280

Interoperability endpoints

  • Direct secure messaging: icosta98504@direct.ahsys.org

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 2

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1952786246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 UNION COUNTY PKWY",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 UNION COUNTY PKWY",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661917",
            "telephone_number": "908-531-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "IRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00578500",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR12516100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

Verify at the official NPI Registry.