JACK MICHAEL COSTA M.D.
NPI 1144393935
Dermatology in Fairfax, VA

Q: What is Jack Costa's NPI number?

The NPI number for Jack Costa is 1144393935. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Q: What is Jack Costa's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Costa was last updated on December 30, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 17, 2006PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

3650 JOSEPH SIEWICK DR, SUITE 202, FAIRFAX, VA 22033(703) 391-2516(703) 476-8244 Get Directions Write a Review

NPPES record last updated: December 30, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Jack Michael Costa M.d. NPPES

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

JACK MICHAEL COSTA M.D. (NPI 1144393935) is an individual dermatology provider in Fairfax, Virginia, licensed in Virginia (0101028288) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of George Washington University School Of Medicine (1971).

NPPES Registry Identity

NPI1144393935

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameJACK MICHAEL COSTACredential: M.D.

Location Address3650 JOSEPH SIEWICK DR, SUITE 202Fairfax, VA 22033-1710

Mailing Address3650 Joseph Siewick Drive, Suite 202Fairfax, VA 22033 · (703) 391-2516 · Fax (703) 476-8244

Phone(703) 391-2516

Fax(703) 476-8244

Sole ProprietorYes

Medical School CMSGeorge Washington University School Of MedicineGraduated 1971

Enumeration DateNovember 17, 2006

Last NPPES UpdateDecember 30, 2010

✔ NPI 1144393935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in VA · 0101028288

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

3650 JOSEPH SIEWICK DR, Fairfax, VA 22033

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Other Identifiers 4

Other003539VA · Anthem

Other9320VA · Blue Cross Blue Shield

Medicare UPINC62572

Medicare ID-Type Unspecified409274

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Michael Costa M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911181961

PECOS Enrollment IDI20110415000235

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.

Areas of Expertise CMS Part B claims 24

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

385 services79 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

290 services144 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

250 services142 patients

Biopsy of surface tissue of leg or ankle 27613

A biopsy of the leg or ankle surface tissue involves removing a small sample of skin for examination. This helps in diagnosing skin conditions or diseases. The area is numbed before a small piece of tissue is taken. It's a safe, quick procedure.

207 services81 patients

Biopsy of surface tissue of thigh or knee 27323

A biopsy of the thigh or knee surface tissue is a procedure where a small sample of your skin or underlying tissue is taken for examination. This helps doctors diagnose conditions such as infections, inflammation, or cancers. It's a safe, routine procedure with minimal discomfort.

194 services92 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

189 services167 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

172 services112 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

172 services91 patients

Biopsy of surface soft tissue to back or lower sides 21920

A biopsy of surface soft tissue on the back or lower sides involves removing a small sample of tissue for examination. This helps in diagnosing diseases or assessing the effectiveness of a treatment. It's a safe, routine procedure with minimal discomfort.

131 services74 patients

Biopsy of surface tissue of upper arm or elbow 24065

A biopsy of the upper arm or elbow involves taking a small sample of surface tissue for examination. This helps in diagnosing conditions like skin diseases or infections. The procedure is usually quick and involves minimal discomfort.

108 services69 patients

Biopsy of soft tissue of neck or chest 21550

A biopsy of soft tissue in the neck or chest involves removing a small sample of tissue for examination. This helps doctors diagnose conditions like infections or cancer. The procedure is usually quick, with minimal discomfort, and recovery is typically swift.

107 services74 patients

Punch biopsy, each additional skin growth 11105

A punch biopsy is a procedure where a small, circular tool removes a sample of your skin growth. This allows for testing to identify the nature of the growth. If there are multiple growths, each additional one may also need a biopsy.

101 services60 patients

Biopsy of surface tissue of shoulder 23065

A biopsy of the shoulder's surface tissue involves removing a small sample of tissue for examination. This procedure helps in diagnosing conditions such as infections, inflammation, or cancer. It's done under local anesthesia, causing minimal discomfort.

87 services63 patients

Biopsy of surface tissue of forearm or wrist 25065

A biopsy of the forearm or wrist involves removing a small piece of surface tissue for examination. This helps in diagnosing diseases or checking the health of your tissue. The procedure is safe, and you may feel slight discomfort.

77 services56 patients

Simple or single drainage of skin abscess 10060

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

59 services50 patients

Complicated or multiple drainage of skin abscess 10061

This procedure involves draining one or more skin abscesses, which are pockets of pus that form due to an infection. The process includes making a small cut on the abscess, removing the pus, and cleaning the area to promote healing and prevent further infection.

35 services31 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

35 services29 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

33 services20 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

27 services17 patients

Biopsy of surface tissue of pelvis and hip 27040

A biopsy of the surface tissue of the pelvis and hip involves taking a small sample of tissue for examination. This helps in diagnosing diseases or checking the health of these areas. It's a safe procedure performed by a skilled professional.

27 services23 patients

Destruction of skin growth, 15 or more growths 17111

"Destruction of skin growth" refers to a procedure where unwanted skin growths, such as warts or moles, are removed. In this case, 15 or more growths are treated. Techniques may include freezing, burning, or laser therapy. It's a safe, quick process to improve skin health.

22 services16 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

18 services16 patients

Removal of skin tag, 1-15 skin tags 11200

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

13 services12 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22033 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

Most-billed visit code 99213

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANE E. DUBINSKY M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

SANDY L. CHUNG M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

SERENE BARMADA-MAZID M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

DR. LAURA E. BYRNES M.D.

Pediatrics

3650 JOSEPH SIEWICK DR, STE 101
FAIRFAX, VA 22033

Fairfax County (703) 391-0900

DR. JOHN B CLEARY M.D.

Internal Medicine (Pulmonary Disease)

3650 JOSEPH SIEWICK DR, STE 307
FAIRFAX, VA 22033

Fairfax County (703) 391-8804

KATHERINE JOYCE COLE MD

Family Medicine

3650 JOSEPH SIEWICK DR, STE 400
FAIRFAX, VA 22033

Fairfax County (703) 391-2020

CRAIG CHARLES CLARK MD

Family Medicine

3650 JOSEPH SIEWICK DR, SUITE 400
FAIRFAX, VA 22033

Fairfax County (703) 391-2020

BRENT R AIN MD

Orthopaedic Surgery

3650 JOSEPH SIEWICK DR, SUITE 300
FAIRFAX, VA 22033

Fairfax County (703) 391-0111

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 Jack Costa's NPI number?

The NPI number for Jack Costa is 1144393935. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Where is Jack Costa located?

Jack Costa practices at 3650 Joseph Siewick Dr Suite 202, Fairfax, VA 22033. The listed phone number is (703) 391-2516.

What is Jack Costa's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Jack Costa enrolled in Medicare?

Yes. Jack Costa is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jack Costa was last updated on December 30, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.