Physician Compare National (NPI:1679694723)

HEALTHCARE PROVIDER: LOUIS E COSTA DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1679694723
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1153413877
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140416000671
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COSTA
	Individual professional last name
Provider First Name	LOUIS
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	230 BEISER BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	DOVER
	Group Practice or individual's city
State	DE
	Group Practice or individual's state
Zip Code	199047792
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3025050045
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	080004
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAYHEALTH HOSPITAL, KENT CAMPUS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y