Jack Michael Costa, MD in Fairfax, VA

Jack Michael Costa, MD is a medicare enrolled "Dermatology" physician in Fairfax, Virginia. He went to George Washington University School Of Medicine and graduated in 1971 and has 53 years of diverse experience with area of expertise as Dermatology. His current practice location is 3650 Joseph Siewick Dr, Suite 202, Fairfax, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 391-2516.

Jack Michael Costa is licensed to practice in Virginia (license number 0101028288) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1144393935.

Contact Information

	Jack Michael Costa, MD
	3650 Joseph Siewick Dr, Suite 202, Fairfax, VA 22033-1710
	(703) 391-2516
	(703) 476-8244

Map and Direction

Physician's Profile

Full Name	Jack Michael Costa
Gender	Male
Speciality	Dermatology
Experience	53 Years
Location	3650 Joseph Siewick Dr, Fairfax, Virginia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jack Michael Costa attended and graduated from George Washington University School Of Medicine in 1971

NPI Data:

NPI Number: 1144393935
Provider Enumeration Date: 11/17/2006
Last Update Date: 12/30/2010

Medicare PECOS Information:

PECOS PAC ID: 7911181961
Enrollment ID: I20110415000235

Medical Identifiers

Medical identifiers for Jack Michael Costa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144393935	NPI	-	NPPES
9320	Other	VA	BLUE CROSS BLUE SHIELD
003539	Other	VA	ANTHEM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	0101028288 (Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jack Michael Costa allows following entities to bill medicare on his behalf.

Entity Name	Jack M. Costa, M.d., P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972808335 PECOS PAC ID: 1759565708 Enrollment ID: O20110415000204

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Michael Costa is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jack Michael Costa, MD 3650 Joseph Siewick Drive, Suite 202, Fairfax, VA 22033 Ph: (703) 391-2516	Jack Michael Costa, MD 3650 Joseph Siewick Dr, Suite 202, Fairfax, VA 22033-1710 Ph: (703) 391-2516

Reviews and Comments

Dermatology Doctors in Fairfax, VA

Benjamin Behnoud Nia, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3700 Joseph Siewick Dr Ste 302, Fairfax, VA 22033 Phone: 703-648-2488 Fax: 703-648-2489
Dr. Caleb Lee, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 10100 Fairfax Blvd, Fairfax, VA 22030 Phone: 703-679-1876
Dr. Monica Nabil Saleh Valentin, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 11351 Random Hills Rd, Fairfax, VA 22030 Phone: 443-351-3376
Dr. Kavya Desai, MD, MPH Dermatology Medicare: Medicare Enrolled Practice Location: 8316 Arlington Blvd Ste 400, Fairfax, VA 22031 Phone: 703-641-0083 Fax: 703-641-0085
Dr. Kathleen Ellison, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8316 Arlington Blvd Ste 400, Fairfax, VA 22031 Phone: 703-641-0083 Fax: 703-641-0085
Etsubdenk Mezemir Ajebo, MD Dermatology Medicare: Medicare Enrolled Practice Location: 4211 Fairfax Corner Ave E # E, Fairfax, VA 22030 Phone: 703-280-1372

Jack Michael Costa, MD - Medicare Dermatology in Fairfax, VA