Mary Dacosta, MD in Alice, TX - Medicare Family Medicine

Mary Dacosta, MD is a medicare enrolled "Family Medicine" physician in Alice, Texas. Her current practice location is 2510 E Main St Ste 102, Alice, Texas. You can reach out to her office (for appointments etc.) via phone at (361) 664-4445.

Mary Dacosta is licensed to practice in Texas (license number V2049) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1255919965.

Contact Information

	Mary Dacosta, MD
	2510 E Main St Ste 102, Alice, TX 78332-4188
	(361) 664-4445
	Not Available

Map and Direction

Physician's Profile

Full Name	Mary Dacosta
Gender	Female
Speciality	Family Medicine
Location	2510 E Main St Ste 102, Alice, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1255919965
Provider Enumeration Date: 04/01/2021
Last Update Date: 07/14/2025

Medicare PECOS Information:

PECOS PAC ID: 9638573264
Enrollment ID: I20240907000448

Medical Identifiers

Medical identifiers for Mary Dacosta such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255919965	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	79645 (Minnesota)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
207Q00000X	Family Medicine	V2049 (Texas)	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. Mary Dacosta allows following entities to bill medicare on her behalf.

Entity Name	Wellmed Medical Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437156486 PECOS PAC ID: 4880657386 Enrollment ID: O20041105000519

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. Mary Dacosta 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
Mary Dacosta, MD 3301 Matlock Rd, Arlington, TX 76015-2908 Ph: (682) 509-6200	Mary Dacosta, MD 2510 E Main St Ste 102, Alice, TX 78332-4188 Ph: (361) 664-4445

Reviews and Comments

Family Medicine Doctors in Alice, TX

Jerry Liles, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1009 E 6th St, Alice, TX 78332 Phone: 361-668-8888
Carlos Rafael Elizondo, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 230 S Gulf St, Alice, TX 78332 Phone: 361-664-0303 Fax: 866-845-0933
Dr. Oscar Reynolds Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 700 Flournoy Rd, Suite 2a, Alice, TX 78332 Phone: 361-664-1417 Fax: 361-664-3218
David Carter, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 E Main St, Alice, TX 78332 Phone: 361-661-8000
Dr. Beauford Basped Jr., D.O Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 102 E Main St, Alice, TX 78332 Phone: 361-664-6504 Fax: 361-664-6531
Dr. Alejandro Lopez Jr., M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 201 Mariposa, Alice, TX 78332 Phone: 361-664-8811 Fax: 361-664-8992

Mary Dacosta, MD - Medicare Family Medicine in Alice, TX