Katherine Elizabeth Costa, ACNP-BC is a medicare enrolled "Nurse Practitioner" physician in Surprise, Arizona. She went to University Of Tennessee, Hsc, College Of Medicine and graduated in 2003 and has 21 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ryan Internal Medicine Pc and her current practice location is
14780 W Mountain View Blvd, Suite 110, Surprise, Arizona. You can reach out to her office (for appointments etc.) via phone at
(623) 374-7774.
Katherine Elizabeth Costa is licensed to practice in Arizona (license number AP3211) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1215014485.
Physician's Profile
| Full Name | Katherine Elizabeth Costa |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 21 Years |
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| Location | 14780 W Mountain View Blvd, Surprise, Arizona |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Katherine Elizabeth Costa attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 2003
NPI Data:
- NPI Number: 1215014485
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 09/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 2264419886
- Enrollment ID: I20090423000212
Medical Identifiers
Medical identifiers for Katherine Elizabeth Costa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215014485 | NPI | - | NPPES |
| P00143146 | Other | MS | MEDICARE UNITEDHEALTHCARE |
| 05132705 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207RP1001X | Internal Medicine - Pulmonary Disease | R862053 (Mississippi) | Secondary |
| 363L00000X | Nurse Practitioner | AP3211 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Ryan Internal Medicine Pc | 4082613708 | 4 |
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. Katherine Elizabeth Costa allows following entities to bill medicare on her behalf.
| Entity Name | Ryan Internal Medicine Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033225024
PECOS PAC ID: 4082613708
Enrollment ID: O20061211000025 |
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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. Katherine Elizabeth 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 |
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Katherine Elizabeth Costa, ACNP-BC
14780 W Mountain View Blvd, Suite 110,
Surprise, AZ 85374-4799
Ph: (623) 374-7774 | Katherine Elizabeth Costa, ACNP-BC
14780 W Mountain View Blvd, Suite 110,
Surprise, AZ 85374-4799
Ph: (623) 374-7774 |
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