Individual provider Active NPI

Candice Da Costa - Pany, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1972052058
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131407 Issued in TX
Practice address
6410 Fannin St
Ste 500
Houston, TX 77030-3000
Phone
(832) 325-6516
Fax
(713) 500-0653
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP131407 TX Primary

Addresses

Primary practice location

6410 Fannin St
Ste 500
Houston, TX 77030-3000

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-5650

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candicedacosta-pany@direct.utphysicians.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161109002794 TX Practitioner - Nurse Practitioner 1658650916 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP131407TXMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cdacosta11333@direct.uth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1972052058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "STE 500",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-6516",
            "fax_number": "713-500-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA COSTA - PANY",
        "first_name": "CANDICE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candicedacosta-pany@direct.utphysicians.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6410 Fannin St",
            "address_2": "STE 500",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770303000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.