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DR. DARY JONATHAN COSTA MD
NPI 1184826273
Otolaryngology - Pediatric Otolaryngology in Louisville, KY

Active since June 01, 2007PECOS Enrolled
411 E CHESTNUT ST # LEVEL6, LOUISVILLE, KY 40202(502) 588-9587(502) 588-9580 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 19, 2022, Feb 17, 2021 (2 updates tracked since 2021).

About Dr. Dary Jonathan Costa Md NPPES

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

DR. DARY JONATHAN COSTA MD (NPI 1184826273) is an individual pediatric otolaryngology provider in Louisville, Kentucky, licensed in Kentucky (TP891) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184826273
Entity TypeIndividualMale
Primary Taxonomy207YP0228X
Provider Legal NameDR. DARY JONATHAN COSTACredential: MD
Location Address411 E CHESTNUT ST # LEVEL6Louisville, KY 40202-1713
Mailing AddressPo Box 776879Chicago, IL 60677-6879 · (502) 588-9490 · Fax (502) 272-5116
Phone(502) 588-9587
Fax(502) 588-9580
Sole ProprietorNo
Enumeration DateJune 1, 2007
Last NPPES UpdateNovember 29, 20232 updates tracked since enumeration
NPPES CertifiedNovember 29, 2023
✔ NPI 1184826273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Pediatric OtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207YP0228X
License✔ Licensed in KY · TP891
Definition
A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.
411 E CHESTNUT ST # LEVEL6, Louisville, KY 40202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dary Jonathan Costa Md 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Dary Costa reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ssm Cardinal Glennon Childrens Hospital
226 mi
Pediatrics
1 SAINT ELIZABETH BLVD
O Fallon, IL 62269
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Ssm Cardinal Glennon Children's Hospital
  • 76 clinicians in this Medicare group
NPI 1174577670 (618) 234-2120
Mercy Clinic Ent LLC
286 mi
Otolaryngology
901 PATIENTS FIRST DR
Washington, MO 63090
  • Reassigned Medicare billing, Missouri enrollment
  • 20 clinicians in this Medicare group
NPI 1366705998 (636) 390-1570

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

ANGELA TRUC DAN CAO MD
Otolaryngology (Pediatric Otolaryngology)
411 E CHESTNUT ST # LEVEL6
LOUISVILLE, KY 40202
Jefferson County (502) 588-9587

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 Dary Costa's NPI number?

The NPI number for Dary Costa is 1184826273. It was assigned to this individual provider in the NPPES registry on June 1, 2007.

Where is Dary Costa located?

Dary Costa practices at 411 E Chestnut St # Level6, Louisville, KY 40202. The listed phone number is (502) 588-9587.

What is Dary Costa's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Pediatric Otolaryngology, with taxonomy code 207YP0228X.

Is Dary Costa enrolled in Medicare?

Yes. Dary Costa is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dary Costa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dary Costa reassigns Medicare benefits to 2 organizations: Ssm Cardinal Glennon Childrens Hospital (O Fallon, IL) and Mercy Clinic Ent LLC (Washington, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dary Costa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dary Costa accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 4 other insurers list Dary Costa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dary Costa was last updated on November 29, 2023. 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.