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

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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 NameJack Michael Costa
GenderMale
SpecialityDermatology
Experience53 Years
Location3650 Joseph Siewick Dr, Fairfax, Virginia
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1144393935NPI-NPPES
9320OtherVABLUE CROSS BLUE SHIELD
003539OtherVAANTHEM

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology 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 NameJack M. Costa, M.d., P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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
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Practice Location: 3700 Joseph Siewick Dr Ste 302, Fairfax, VA 22033
Phone: 703-648-2488    Fax: 703-648-2489
Dr. Caleb Lee, D.O.
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Medicare: Accepting Medicare Assignments
Practice Location: 10100 Fairfax Blvd, Fairfax, VA 22030
Phone: 703-679-1876    
Dr. Monica Nabil Saleh Valentin, M.D.
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Practice Location: 11351 Random Hills Rd, Fairfax, VA 22030
Phone: 443-351-3376    
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
Dr. Amanda Derwae, M.D.
Dermatology
Medicare: Medicare Enrolled
Practice Location: 10680 Main St Ste 200, Fairfax, VA 22030
Phone: 703-352-2620    
Dr. Rolla Jaber, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 3700 Joseph Siewick Dr, Suite 403, Fairfax, VA 22033
Phone: 703-648-2488    Fax: 703-648-2489

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.