Lisa Costa, CNP in Pembroke, MA - Medicare Nurse Practitioner

Lisa Costa, CNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Pembroke, Massachusetts. Her current practice location is 20 Winter St, Pembroke, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (781) 887-7377.

Lisa Costa is licensed to practice in Massachusetts (license number RN197629) 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 1790335214.

Contact Information

	Lisa Costa, CNP
	20 Winter St, Pembroke, MA 02359-4965
	(781) 887-7377
	Not Available

Map and Direction

Provider's Profile

Full Name	Lisa Costa
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	20 Winter St, Pembroke, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790335214
Provider Enumeration Date: 09/17/2019
Last Update Date: 05/08/2025

Medicare PECOS Information:

PECOS PAC ID: 6204246952
Enrollment ID: I20210304002831

Medical Identifiers

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

Identifier	Type	State	Issuer
1790335214	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	197629 (Massachusetts)	Secondary
363L00000X	Nurse Practitioner	197629 (Massachusetts)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN197629 (Massachusetts)	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. Lisa Costa allows following entities to bill medicare on her behalf.

Entity Name	Northeast Health Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225067481 PECOS PAC ID: 6901866706 Enrollment ID: O20041015000643

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. Lisa 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
Lisa Costa, CNP 79 Barstow Ave, Norwell, MA 02061-2831 Ph: () -	Lisa Costa, CNP 20 Winter St, Pembroke, MA 02359-4965 Ph: (781) 887-7377

Reviews and Comments

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Lisa Costa, CNP - Medicare Nurse Practitioner in Pembroke, MA