DACOSTA MEDICAL GROUP LLC (NPI# 1346461282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346461282 |
| Entity Type | Organization |
| Organization Name | DACOSTA MEDICAL GROUP LLC |
| Practice Address |
85 S Jefferson Street Orange NJ 07050 |
| Practice Telephone | 9736748866 |
| Practice Fax Number | 9736729299 |
| Mailing Telephone | 9736748866 |
| Mailing Fax Number | 9736729299 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-04-23 |
| Authorized Official Name | DR. THEODORE DACOSTA (PHYSICIAN) |
| Authorized Official Telephone | 9736748866 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 9078908 | 05 |
| Street Address |
85 S JEFFERSON STREET |
| City | ORANGE |
| State | NJ |
| Zip Code | 07050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699708586 | Theodore A Dacosta Sr. | Internal Medicine | 85 S Jefferson Street, Orange, NJ 07050 | 2006-07-07 |
| 1558395673 | Theodore A Dacosta Jr. | Internal Medicine | 85 S Jefferson Street, Orange, NJ 07050 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013574516 | Idrissa Cisse | Non-emergency Medical Transport (VAN) | 493 Valley Street, Apt 8, Orange, NJ 07050 | 2019-05-21 |
| 1487218277 | Pioneer Homecare of Nj, Inc. | Home Health | 14 South Center Street, Orange, NJ 07050 | 2019-04-26 |
| 1518521392 | Pioneer Hospice of Nj, Inc. | Hospice Care, Community Based | 14 South Center Street Unit 102, Orange, NJ 07050 | 2019-04-26 |
| 1326507500 | Jenny G Joseph | Licensed Practical Nurse | 787 Vose Ave, Apt A15, Orange, NJ 07050 | 2019-03-18 |
| 1790263309 | Bhuvaneswari Potti | Pharmacist | E & M Pharmacy, 205 S Essex Ave, Orange, NJ 07050 | 2018-08-06 |
| 1013397975 | The Arc of Essex County, Inc. | Respite Care | 46-56 Oakwood Avenue, Orange, NJ 07050 | 2015-06-05 |
| 1942688106 | Jennifer A Unger | Counselor | 395 South Center Street, Orange, NJ 07050 | 2015-05-08 |
| 1649692393 | Patricia Roc | Licensed Practical Nurse | 400 Highland Terrace, 5c, Orange, NJ 07050 | 2014-01-15 |
| 1942585443 | Najmusseher Khan | Pharmacist | 240-250 Central Ave, Orange, NJ 07050 | 2011-10-15 |
| 1558536607 | Alphonse Ronald Flora | Internal Medicine | 479 Fairview Ave, Orange, NJ 07050 | 2008-04-29 |
| Find all providers in zip 07050 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392008 | Insite Digestive Health Care | Internal Medicine | 1010 W La Veta Ave Ste 570, Orange, CA 92868-4305 | 2017-12-21 |
| 1043637234 | Jennifer Kolb | Internal Medicine | 333 City Tower W 4th Floor, Orange, CA 92868 | 2014-03-25 |
| 1912010257 | Haig Najarian | Internal Medicine | 1010 W La Veta, Suite 570, Orange, CA 92868-4223 | 2006-08-17 |
| 1881652998 | William E Karnes Jr. | Internal Medicine | 101 The City Dr S Bldg 22c, Orange, CA 92868-3201 | 2006-05-01 |
| 1609859842 | Karen Shanahan Dufour | Internal Medicine | 325 Boston Post Rd, Orange, CT 06477-3504 | 2005-11-22 |
| 1710403498 | Kyle Joshua Fortinsky | Internal Medicine | 333 City Blvd W Ste 400, Orange, CA 92868-2994 | 2017-08-15 |
| 1992125025 | Robin Zachariah | Internal Medicine | 333 City Blvd W, Department of Gastroenterology, Suite 400, Orange, CA 92806 | 2014-04-16 |
| 1093133183 | Christina Ling | Internal Medicine | 333 City Blvd W Ste 400, Orange, CA 92868-2994 | 2014-04-04 |
| 1538506597 | Neetika Srivastava | Internal Medicine | 101 The City Dr S, Orange, CA 92868-3201 | 2013-05-31 |
| 1821356254 | Mark Samir Salem | Internal Medicine | 101 The City Dr S Ste 400, Orange, CA 92868-3201 | 2012-04-23 |
| Find all providers in ORANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.