Jack M. Costa, M.D., P.C.
NPI 1972808335ActiveOrganization· Specialist· Fairfax, VA
Specialist in Fairfax, Virginia, registered in NPPES in January 2011. The authorized official on file is Jack M. Costa, M.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1972808335 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 17, 2011 |
| Last updated in NPPES | Jan 17, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 0101028288 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC) |
|---|
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