THEODORE R DACOSTA DO
NPI 1114420155
Internal Medicine - Gastroenterology in West Orange, NJ

Q: What is Theodore Dacosta's NPI number?

The NPI number for Theodore Dacosta is 1114420155. It was assigned to this individual provider in the NPPES registry on March 15, 2018.

Q: What is Theodore Dacosta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Dacosta was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 15, 2018PECOS Enrolled

59 MAIN ST STE 1, WEST ORANGE, NJ 07052(973) 674-8866 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Theodore R Dacosta Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE R DACOSTA DO (NPI 1114420155) is an individual gastroenterology provider in West Orange, New Jersey, licensed in New Jersey (25MB12193600) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in West Orange.

NPPES Registry Identity

NPI1114420155

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameTHEODORE R DACOSTACredential: DO

Location Address59 MAIN ST STE 1West Orange, NJ 07052-5341

Mailing Address26 Mcchesney CtWest Orange, NJ 07052-1135 · (973) 699-3950

Phone(973) 674-8866

Sole ProprietorNo

Enumeration DateMarch 15, 2018

Last NPPES UpdateMay 30, 2024

NPPES CertifiedMay 30, 2024

✔ NPI 1114420155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · 25MB12193600

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

59 MAIN ST STE 1, West Orange, NJ 07052

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Secondary Practice Location 1

Location 126 McChesney CtWest Orange, NJ 07052-1135 · Phone (973) 699-3950

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore R Dacosta Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07052 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Dacosta's NPI number?

The NPI number for Theodore Dacosta is 1114420155. It was assigned to this individual provider in the NPPES registry on March 15, 2018.

Where is Theodore Dacosta located?

Theodore Dacosta practices at 59 Main St Ste 1, West Orange, NJ 07052. The listed phone number is (973) 674-8866.

What is Theodore Dacosta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Theodore Dacosta enrolled in Medicare?

Yes. Theodore Dacosta is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theodore Dacosta was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.